CONNECTICUT SURGICAL GROUP, PC NPI 1023291622

Urology in Meriden, CT

NPI 1023291622 Organization Urology CLIA Number 07D2139768 CLIA Certificate of Waiver

About CONNECTICUT SURGICAL GROUP, PC

Connecticut Surgical Group, Pc is a provider established in Meriden, Connecticut specializing in urology. The NPI number of Connecticut Surgical Group, Pc is 1023291622 and was assigned on December 2007. The practitioner's primary taxonomy code is 208800000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. Connecticut Surgical Group, Pc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Douglas C Mckell (Chief Administrative Officer)

The CLIA number of Connecticut Surgical Group, Pc is 07D2139768 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Connecticut Surgical Group, Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1023291622

Provider NameCONNECTICUT SURGICAL GROUP, PC
Provider Location Address455 LEWIS AVE SUITE 210 MERIDEN, CT 06451
Provider Mailing Address17 TALCOTT NOTCH RD FARMINGTON, CT 06032
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date12-06-2007
Last Update Date08-11-2010


Primary Taxonomy

Taxonomy Code208800000X
ClassificationUrology
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Business Address

CONNECTICUT SURGICAL GROUP, PC
455 LEWIS AVE
SUITE 210
MERIDEN, CT
ZIP 06451
Phone: (203) 238-1241
Fax: (203) 686-0791

Get Directions


Mailing Address

CONNECTICUT SURGICAL GROUP, PC
17 TALCOTT NOTCH RD
FARMINGTON, CT
ZIP 06032
Phone: (860) 524-2626
Fax: (860) 677-5029



Authorized Official

Authorized Official Name DOUGLAS C MCKELL
Authorized Official TitleCHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone(860) 524-4326

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1023291622 is:

CLIA Number07D2139768
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryNo

Taxonomy Description: a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

2208600000XAllopathic & Osteopathic PhysiciansSurgeryNo

Taxonomy Description: a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

32086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryNo

Taxonomy Description: a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

4208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryNo

Taxonomy Description: a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

5213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristNo

Taxonomy Description: a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
50CONNSURCT01OTHER (01)CT
004139350MEDICAID (05)CT
1028630012MEDICARE NSC (07)CT
C01687MEDICARE PIN (08)

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1710986898DR. DAVID M SACK M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 105
MERIDEN, CT 06451
(203) 237-2477
1629077714DR. HOUSEIN M WAZAZ M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 105
MERIDEN, CT 06451
(203) 237-2477
1659363042DR. RICHARD PETER GIOSA MD
Individual
Internal Medicine (Pulmonary Disease)455 LEWIS AVE SUITE 200
MERIDEN, CT 06451
(203) 238-9446
1063464261DR. AURANGZEB A ALI M.D.
Individual
Surgery455 LEWIS AVE SUITE 216
MERIDEN, CT 06451
(203) 634-0134
1669426508DR. PETER D LEFF M.D.
Individual
Surgery455 LEWIS AVE SUITE 216
MERIDEN, CT 06451
(203) 634-0134
1356380232 GARY F TANSINO MD
Individual
Internal Medicine (Hematology & Oncology)455 LEWIS AVE SUITE 102
MERIDEN, CT 06451
(203) 238-7747
1770524753 GERARD FUMO DO
Individual
Internal Medicine (Hematology & Oncology)455 LEWIS AVE SUITE 102
MERIDEN, CT 06451
(203) 238-7747
1821034117MR. RAYMOND TIMOTHY RYAN PT
Individual
Physical Therapist455 LEWIS AVE
MERIDEN, CT 06451
(203) 935-0463
1487677951MIDSTATE GASTROENTEROLOGY SPECIALISTS PC
Organization
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 105
MERIDEN, CT 06451
(203) 237-2477
1093738197 GARY MARK COHEN M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 106
MERIDEN, CT 06451
(203) 886-0036
1326062464 DOUGLAS T MILLER M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 106
MERIDEN, CT 06451
(203) 886-0036
1598789653 JON J ERNSTOFF M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 106
MERIDEN, CT 06451
(203) 886-0036
1073521423 LOUIS MEYER MD
Individual
Surgery455 LEWIS AVE
MERIDEN, CT 06451
(203) 238-2691
1003823683 KEVIN JO M.D.
Individual
Internal Medicine (Gastroenterology)455 LEWIS AVE SUITE 106
MERIDEN, CT 06451
(203) 886-0036
1205844677 AZIZ BENBRAHIM MD
Individual
Surgery455 LEWIS AVE
MERIDEN, CT 06451
(203) 238-2691
1194735894UROLOGICAL ASSOCIATES OF CENTRAL CT
Organization
Urology455 LEWIS AVE SUITE 210
MERIDEN, CT 06451
(203) 238-1241
1528078995 ELIZABETH C. RIORDAN M.D.
Individual
Surgery455 LEWIS AVE SUITE 208
MERIDEN, CT 06451
(203) 238-2691
1689770950DR. RICHARD A SMITH MD
Individual
Internal Medicine (Pulmonary Disease)455 LEWIS AVE STE 205
MERIDEN, CT 06451
(203) 639-7272
1902992514DR. JUSTIN TYRONE MONTANYE MD
Individual
Psychiatry & Neurology (Neurology)455 LEWIS AVE SUITE 221
MERIDEN, CT 06451
(203) 694-8550
1851474126 KENNETH R KURZ
Individual
Urology455 LEWIS AVE STE 210
MERIDEN, CT 06451
(203) 238-1241

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.