Active NPI
Penny Ann Lowenstein, MD
- Dermatology Physician
- Glastonbury, CT
National Provider Identifier
1992798292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 024887
- Practice address
- 210 New London Tpke
Glastonbury, CT 06033-2235 - Phone
- (860) 633-1543
- Fax
- (860) 659-9755
- NPI assigned
- Aug 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 024887 | CT | Primary |
Addresses
Primary practice location
210 New London Tpke
Glastonbury, CT 06033-2235
Mailing address
210 New London Tpke
Glastonbury, CT 06033-2235
Phone (860) 633-1543
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052530 | Other | CT | CONNECTICARE |
| 669512 | Other | CT | AETNA |
| 010024887CT02 | Other | CT | ANTHEM BC/BS OF CT |
| 3739162002 | Other | CT | CIGNA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110630000400 | CT | Practitioner - Dermatology | 6608054200 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024887 | CT | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1992798292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332235",
"telephone_number": "860-633-1543",
"fax_number": "860-659-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332235",
"telephone_number": "860-633-1543",
"fax_number": "860-659-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOWENSTEIN",
"first_name": "PENNY",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-23",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CT",
"license": "024887",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "052530",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "669512",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS OF CT",
"identifier": "010024887CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3739162002",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.