| Rainer Wolf Bagdasarian, MD | |
|
25 Newell Rd, Suite D28, Bristol, CT 06010 | |
| (860) 583-2003 | |
| (860) 582-6255 |
| Full Name | Rainer Wolf Bagdasarian |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 30 Years |
| Location | 25 Newell Rd, Bristol, Connecticut |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013025295 | NPI | - | NPPES |
| 001383653 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 038365 (Connecticut) | Primary |
| 2086S0129X | Surgery - Vascular Surgery | 038365 (Connecticut) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bristol Hospital | Bristol, CT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bristol Hospital Multi-specialty Group, Inc. | 9032014758 | 130 |
| 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 |
|---|---|
| Rainer Wolf Bagdasarian, MD 25 Newell Rd, Suite D28, Bristol, CT 06010 Ph: (860) 583-2003 | Rainer Wolf Bagdasarian, MD 25 Newell Rd, Suite D28, Bristol, CT 06010 Ph: (860) 583-2003 |
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: Medicare Enrolled 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 | |
Daniel Joseph Scoppetta, MD Surgery Medicare: Medicare Enrolled Practice Location: 25 Newell Rd, Suite D28, Bristol, CT 06010 Phone: 860-582-1220 Fax: 860-582-6255 |