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AVANTA CLINIC LLC
NPI 1619467826
Internal Medicine in Glastonbury, CT

Active since May 14, 2018CLIA 07D2149140 · Waiver
131 NEW LONDON TPKE STE 105, GLASTONBURY, CT 06033(860) 430-5599 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 4, 2026, Aug 28, 2018, May 14, 2018 (3 updates tracked since 2018).

About Avanta Clinic Llc NPPES

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

AVANTA CLINIC LLC (NPI 1619467826) is a healthcare organization registered as an internal medicine in Glastonbury, Connecticut and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through May 24, 2028 and lists Sudeep Bansal, Owner, as its authorized official.

NPPES Registry Identity

NPI1619467826
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameAVANTA CLINIC LLC
Location Address131 NEW LONDON TPKE STE 105Glastonbury, CT 06033
Mailing Address131 New London Tpke Ste 105Glastonbury, CT 06033-2246
Phone(860) 430-5599
Organization SubpartNo
Authorized OfficialSudeep BansalOwner · (860) 430-5599
Enumeration DateMay 14, 2018
Last NPPES UpdateMay 4, 20263 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
✔ NPI 1619467826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
131 NEW LONDON TPKE STE 105, Glastonbury, CT 06033
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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 SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2149140

Avanta Clinic LLC · Glastonbury, CT
Active · expires May 24, 2028
CLIA Number07D2149140
Laboratory TypePhysician Office
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorSudeep Bansal
Laboratory Phone(860) 430-5599
Laboratory LocationAvanta Clinic LLC131 New London Tpke, Ste 105, Glastonbury, CT 06033
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUDEEP BANSAL M.D.
Internal Medicine
131 NEW LONDON TPKE STE 105
GLASTONBURY, CT 06033
Capitol Planning Region (860) 430-5599
ROBIN J BANSAL
Nurse Practitioner
131 NEW LONDON TPKE STE 105
GLASTONBURY, CT 06033
Capitol Planning Region (860) 430-5599
AMY CLOSE APRN
Nurse Practitioner
131 NEW LONDON TPKE STE 105
GLASTONBURY, CT 06033
Capitol Planning Region (860) 430-5599

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 Avanta Clinic LLC's NPI number?

The NPI number for Avanta Clinic LLC is 1619467826. It was assigned to this organization in the NPPES registry on May 14, 2018.

Where is Avanta Clinic LLC located?

Avanta Clinic LLC is located at 131 New London Tpke Ste 105, Glastonbury, CT 06033. The listed phone number is (860) 430-5599.

What is Avanta Clinic LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Avanta Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2149140) is associated with this NPI, valid through May 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avanta Clinic LLC was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.