Connecticut Surgical Group, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CONNECTICUT SURGICAL GROUP, PC

Practice address

98 Main St
Suite 303
Southington, CT 06489-2500

Phone

(203) 238-1241

Fax

(860) 686-0791

NPI assigned

Nov 28, 2005

Organization subpart

No

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

Authorized official

Name

Douglas C McKell

Title

Chief Administrative Officer

Phone

(860) 524-4326

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 4

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

• Kenneth R Kurz

  • Urology Physician
  • Meriden, CT
  • NPI 1851474126
  NPD (past)
• Komsu F Mamuya, MD

  • Cardiovascular Disease Physician
  • Wethersfield, CT
  • NPI 1073588695
  NPD (past)
• Paul Vincent Vignati, MD

  • Colon & Rectal Surgery Physician
  • Hartford, CT
  • NPI 1730174350
  NPD (past)
• Brian Wirtalla, DPT, CSCS

  • Physical Therapist
  • Manchester, CT
  • NPI 1659799823
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1972586675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 TALCOTT NOTCH RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321818",
            "telephone_number": "860-524-2626",
            "fax_number": "860-677-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 MAIN ST",
            "address_2": "SUITE 303",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892500",
            "telephone_number": "203-238-1241",
            "fax_number": "860-686-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT SURGICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "MCKELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "860-524-4326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004139350",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "50CONNSURCT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Orthopedics & Musculoskeletal Care LLC
• Comprehensive Orthopedics & Musculoskeletal Care LLC
• Connecticut CVS Pharmacy LLC
• Connecticut CVS Pharmacy LLC
• Connecticut Support Services Holdings, LLC
• Caitlin Grace Connolly, OTR/L
• Lisa Desiderio Consiglio, APRN
• Constant Dental Care, PLLC
• Core Podiatry LLC
• Core Principles

• Durable Medical Equipment & Medical Supplies in Southington, CT
• Providers in Southington, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.