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HOLISTIC FAMILY MEDICINE LLC
NPI 1114269032
Family Medicine in Ridgefield, CT

Active since March 18, 2013
430 OLD SIB RD, RIDGEFIELD, CT 06877(203) 826-3582(855) 798-2816 Get Directions Write a Review

NPPES record last updated: March 18, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Holistic Family Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLISTIC FAMILY MEDICINE LLC (NPI 1114269032) is a healthcare organization registered as a family medicine in Ridgefield, Connecticut and active in the NPI registry since March 2013. The organization lists Domenick John Masiello, Owner, as its authorized official.

NPPES Registry Identity

NPI1114269032
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHOLISTIC FAMILY MEDICINE LLC
Location Address430 OLD SIB RDRidgefield, CT 06877-2335
Mailing Address430 Old Sib RdRidgefield, CT 06877-2335 · (203) 826-3582 · Fax (855) 798-2816
Phone(203) 826-3582
Fax(855) 798-2816
Organization SubpartNo
Authorized OfficialDomenick John MasielloOwner · (203) 826-3582
Enumeration DateMarch 18, 2013
✔ NPI 1114269032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CT · 000278
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNeuromusculoskeletal Medicine & OMMTaxonomy 204D00000X · License 000278 (CT)
430 OLD SIB RD, Ridgefield, CT 06877
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holistic Family Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateConnecticutEnrollment IDO20130319000003Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Holistic Family Medicine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Domenick Masiello, DO
Osteopathic Manipulative Medicine
NPI 1184747305
430 OLD SIB RD
Ridgefield, CT 06877
(203) 826-3582
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holistic Family Medicine LLC's NPI number?

The NPI number for Holistic Family Medicine LLC is 1114269032. It was assigned to this organization in the NPPES registry on March 18, 2013.

Where is Holistic Family Medicine LLC located?

Holistic Family Medicine LLC is located at 430 Old Sib Rd, Ridgefield, CT 06877. The listed phone number is (203) 826-3582.

What is Holistic Family Medicine LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Holistic Family Medicine LLC enrolled in Medicare?

Yes. Holistic Family Medicine LLC is registered in the Medicare PECOS enrollment system.

When is Holistic Family Medicine LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Connecticut, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Holistic Family Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Osteopathic Manipulative Medicine) reassigns their Medicare billing to Holistic Family Medicine LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Holistic Family Medicine LLC was last updated on March 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.