| Genesis Eldercare Physician Services LLC | |
|
1 Emerson Dr Kimberly Hall North Windsor CT 06095 | |
| (860) 688-6443 | |
| (860) 688-5230 |
| Full Name | Genesis Eldercare Physician Services LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Emerson Dr, Windsor, Connecticut |
| Authorized Official Name and Position | Eric Shapiro (VP, AREA CONTROLLER) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Eldercare Physician Services LLC Po Box 62946 Baltimore MD 21264-2946 Ph: (410) 494-7607 | Genesis Eldercare Physician Services LLC 1 Emerson Dr Kimberly Hall North Windsor CT 06095 Ph: (860) 688-6443 |
| NPI Number | 1164415196 |
|---|---|
| Provider Enumeration Date | 08/24/2005 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20031110000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164415196 | NPI | - | NPPES |
| 004195021 | Medicaid | CT | |
| 004126919 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (Connecticut) | Primary |
| Provider Name | Fielding Johnson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1346336237 PECOS PAC ID: 0345140927 Enrollment ID: I20040114000083 |
| Provider Name | Sharon Farber |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1073596714 PECOS PAC ID: 9739124322 Enrollment ID: I20050623000803 |
| Provider Name | Rabindranath Mahabir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346328044 PECOS PAC ID: 4385717750 Enrollment ID: I20080717000477 |
| Provider Name | James P Gallagher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801817325 PECOS PAC ID: 8527007665 Enrollment ID: I20090423000095 |
| Provider Name | Benjamin Yeboah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174705636 PECOS PAC ID: 6800085945 Enrollment ID: I20110105000888 |
| Provider Name | Elizabeth R Christison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275876286 PECOS PAC ID: 0840432480 Enrollment ID: I20130812000658 |
| Provider Name | Sunil Paul Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710966775 PECOS PAC ID: 0749188977 Enrollment ID: I20150514000171 |
| Provider Name | Savitha Chandramohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316571458 PECOS PAC ID: 4385069939 Enrollment ID: I20200730001076 |
| Provider Name | Anita Ngozi Obidigbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700558608 PECOS PAC ID: 2264821347 Enrollment ID: I20211110002582 |
Heritage Direct Care, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 61 Bloomfield Ave, Windsor, CT 06095 Phone: 860-687-5722 |
Total Medical Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 Broad St, Windsor, CT 06095 Phone: 860-688-8888 Fax: 860-688-6381 |
Easter Seals Capitol Region and Eastern Connecticut Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Deerfield Road, Windsor, CT 06095 Phone: 860-270-0600 |
Genesis Eldercare Physician Services I LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Emerson Dr, Kimberly Hall North, Windsor, CT 06095 Phone: 410-543-1957 |
Windsor Medical Associates LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Mack St, Windsor, CT 06095 Phone: 860-298-8830 Fax: 860-298-9929 |
Health One Physician Associates LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 Marshall Phelps Road, Windsor, CT 06095 Phone: 860-683-0756 Fax: 860-683-1555 |