Organization Active NPI

Doctors Office CT PLLC

  • Internal Medicine Physician
  • Cos Cob, CT
National Provider Identifier
1962997940
Registry record updated May 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DOCTORS OFFICE CT PLLC
Practice address
40 E Putnam Ave Ste 1B
Cos Cob, CT 06807-2606
Phone
(203) 489-5442
Fax
(203) 325-3270
NPI assigned
Jun 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joshan K Shajan, MDNPI 1790043040
Title
Manager
Phone
(203) 325-2120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

40 E Putnam Ave Ste 1B
Cos Cob, CT 06807-2606

Mailing address

212 Bible St
Cos Cob, CT 06807-1322
Phone (646) 652-1791

Other practice location 1

90 Morgan St Ste 103
Stamford, CT 06905-5436
Phone (203) 325-2120

Other names 1

  • NEW CANAAN URGENT CARE PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190722001186 CT Part B Supplier - Clinic/Group Practice 1759617244 Receives reassigned benefits from 2 practitioners
Practice locations: Cos Cob, CT; Stamford, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0940019Doctors Office CT PLLC90 Morgan Street Suite 103, Stamford, CT 06905Certificate of waiverFeb 3, 2028
07D2281938Doctors Office CT PLLC40 East Putnam Ave, Ste 1B, Cos Cob, CT 06807Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Locations

40 E Putnam Ave
Ste 1B
Cos Cob, CT 06807
Phone (203) 249-5442

90 Morgan St
Ste 103
Stamford, CT 06905
Phone (203) 325-2120

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684022400000",
    "number": "1962997940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BIBLE ST",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068071322",
            "telephone_number": "646-652-1791",
            "fax_number": "888-981-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E PUTNAM AVE STE 1B",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072606",
            "telephone_number": "203-489-5442",
            "fax_number": "203-325-3270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Morgan St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069055436",
            "country_code": "US",
            "telephone_number": "203-325-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOCTORS OFFICE CT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-05-14",
        "certification_date": "2023-05-14",
        "status": "A",
        "authorized_official_last_name": "SHAJAN",
        "authorized_official_first_name": "JOSHAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-325-2120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW CANAAN URGENT CARE PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.