Organization Active NPI

Harvey J Bluestein MD LLC

  • Plastic Surgery Physician
  • Fairfield, CT
National Provider Identifier
1982959334
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
037483 Issued in CT
Legal business name
HARVEY J BLUESTEIN MD LLC
Practice address
325 Reef Rd
Suite 105
Fairfield, CT 06824-6537
Phone
(203) 254-8557
NPI assigned
Jul 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Authorized official

Name
Dr. Harvey Jay Bluestein, MDNPI 1528134830
Title
Sole Proprietor/Surgeon
Phone
(203) 254-8557

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
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 037483 CT Primary

Addresses

Primary practice location

325 Reef Rd
Suite 105
Fairfield, CT 06824-6537

Mailing address

325 Reef Rd
Suite 105
Fairfield, CT 06824-6537
Phone (203) 254-8557

Other identifiers 2

IdentifierTypeStateIssuer
240000139OtherCTMEDICARE
001374834MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120906000732 CT Part B Supplier - Clinic/Group Practice 4082862586 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfield, CT

National Provider Directory

National Provider Directory

Locations

1735 Post Rd
Fairfield, CT 06824
Phone (203) 256-3990

1735 Post Rd
Ste 4
Fairfield, CT 06824
Phone (203) 254-8557

Practitioners & affiliated clinicians

Practitioners 1

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": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1982959334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 REEF RD",
            "address_2": "SUITE 105",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246537",
            "telephone_number": "203-254-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 REEF RD",
            "address_2": "SUITE 105",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246537",
            "telephone_number": "203-254-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEY J BLUESTEIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "BLUESTEIN",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/SURGEON",
        "authorized_official_telephone_number": "203-254-8557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "037483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "240000139",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001374834",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.