Individual provider Active NPI

Wigneswaran W Paramanathan, M.D.

  • Internal Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1982663126
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036247 Issued in CT
Practice address
226 Mill Hill Ave
3Rd Floor
Bridgeport, CT 06610-2811
Phone
(203) 384-3873
Fax
(203) 384-3829
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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 036247 CT Primary

Addresses

Primary practice location

226 Mill Hill Ave
3Rd Floor
Bridgeport, CT 06610-2811

Mailing address

20 York Street, CB-329
New Haven, CT 06510-3220
Phone (203) 384-4677

Other practice location 1

267 Grant Street
Bridgeport, CT 06610-2805
Phone (203) 384-4677

Other identifiers 1

IdentifierTypeStateIssuer
001362475MedicaidCT

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
I20100525000764 CT Practitioner - Internal Medicine 2062541360 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036247CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc CurrentSince Jul 1, 1998 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 1998 Accepting new patients
Northeast Medical Group, PLLC Internal Medicine PastSince May 31, 2020 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1982663126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-329",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-384-4677",
            "fax_number": "203-384-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MILL HILL AVE",
            "address_2": "3RD FLOOR",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102811",
            "telephone_number": "203-384-3873",
            "fax_number": "203-384-3829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant Street",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066102805",
            "country_code": "US",
            "telephone_number": "203-384-4677",
            "fax_number": "203-384-3135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARAMANATHAN",
        "first_name": "WIGNESWARAN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001362475",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.