Individual provider Active NPI

Vadim Tikhomirov, MD

  • Internal Medicine Physician
  • Danbury, CT
National Provider Identifier
1982649836
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
037705 Issued in CT
Practice address
95 Locust Ave
Danbury, CT 06810-6148
Phone
(203) 797-7173
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 037705 CT Primary

Addresses

Primary practice location

95 Locust Ave
Danbury, CT 06810-6148

Mailing address

79 Sand Pit Road
Suite 102
Danbury, CT 06810
Phone (203) 749-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000456 CT Practitioner - Family Practice 6608050794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

79 Sand Pit Rd
Suite 102
Danbury, CT 06810-4010
Phone (203) 749-5700

Hospital & facility affiliations

  • Western Connecticut Home Care Inc Home health agency, Danbury, CT, CCN 077088
  • Rvnahealth Home health agency, Ridgefield, CT, CCN 077066
  • Elara Caring Home health agency, Rocky Hill, CT, CCN 077163
  • Regional Hospice Hospice, Danbury, CT, CCN 071518
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
037705CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Sep 1, 1999 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

79 Sand Pit Rd
Ste 202
Danbury, CT 06810

79 Sand Pit Rd
Ste 102
Danbury, CT 06810
Phone (203) 749-5700

79 Sand Pit Rd
Danbury, CT 06810
Phone (203) 749-5700

95 Locust Ave
Danbury, CT 06810
Phone (203) 739-7029

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1982649836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SAND PIT ROAD",
            "address_2": "SUITE 102",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-749-5700",
            "fax_number": "203-749-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LOCUST AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106148",
            "telephone_number": "203-797-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIKHOMIROV",
        "first_name": "VADIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "037705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.