| Daniel Joseph Scoppetta, MD | |
| 25 Newell Rd, Suite D28, Bristol, CT 06010-5100 | |
| (860) 582-1220 | |
| (860) 582-6255 | 
| Full Name | Daniel Joseph Scoppetta | 
|---|---|
| Gender | Male | 
| Speciality | Surgery | 
| Location | 25 Newell Rd, Bristol, Connecticut | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1578587705 | NPI | - | NPPES | 
| 001205913 | Medicaid | CT | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | 020591 (Connecticut) | Primary | 
| Entity Name | Bristol Hospital Multi-specialty Group, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1649265679 PECOS PAC ID: 9032014758 Enrollment ID: O20031204000960 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Daniel Joseph Scoppetta, MD Po Box 2828, Bristol, CT 06011-2828 Ph: (860) 585-3906 | Daniel Joseph Scoppetta, MD 25 Newell Rd, Suite D28, Bristol, CT 06010-5100 Ph: (860) 582-1220 | 
| Rainer Wolf Bagdasarian, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 25 Newell Rd, Suite D28, Bristol, CT 06010 Phone: 860-583-2003 Fax: 860-582-6255 | |
| Khaula Khatlani, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 975 Farmington Ave Ste 1, Bristol, CT 06010 Phone: 860-589-0114 Fax: 860-589-1936 | |
| Kenneth George Benoit, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 85 Beleden Gardens Drive, Bristol, CT 06010 Phone: 860-582-1220 Fax: 860-582-6255 | |
| Larissa Nkouami Pamen, MD Surgery Medicare: Medicare Enrolled Practice Location: 41 Brewster Rd, Bristol, CT 06010 Phone: 860-585-3966 | |
| James Thomas Sayre, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 85 Beleden Gardens Dr, Bristol, CT 06010 Phone: 860-582-1220 Fax: 860-582-6255 | |
| Sai Varanasi, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 41 Brewster Rd, Bristol, CT 06010 Phone: 860-585-3000 |