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Contact Information

MIDSTATE MEDICAL GROUP, PC
98 MAIN ST STE 300
SOUTHINGTON, CT06489-2500
 Phone: 203-694-5580
 Fax: 860-620-0446
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

Neurology

2084N0400X 13 Physician/Neurology
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
 

Surgery

208600000X 02 Physician/General Surgery
 

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MIDSTATE MEDICAL GROUP, PC

NPI Number 1427089598
LBN Legal business name MIDSTATE MEDICAL GROUP, PC
Authorized official RALPH BECKER - (VICE PRESIDENT, FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 07/06/2006
Last updated 08/24/2012 - About 14 years ago
Identifiers
CT Medicaid 004260022
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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