FAMILY PRACTICE & INTERNAL MEDICINE, LLC
NPI 1902095003
Internal Medicine in North Haven, CT
NPI Status: Active since October 15, 2007
Contact Information
52 WASHINGTON AVE
SUITE 4
NORTH HAVEN, CT
ZIP 06473
Phone: (203) 672-2800
Fax: (203) 672-2801
- Organization
- Internal Medicine
- CLIA Number: 07D1070751
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-08-2025
About FAMILY PRACTICE & INTERNAL MEDICINE, LLC
This page provides the complete NPI Profile along with additional information for Family Practice & Internal Medicine, Llc, an internist established in North Haven, Connecticut operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1902095003 assigned on October 2007. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Fausto Petruzziello Md (Owner)
- NPI
- 1902095003
- Provider Name
- FAMILY PRACTICE & INTERNAL MEDICINE, LLC
- Entity Type
- Organization
- Location Address
- 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473
- Location Phone
- (203) 672-2800
- Location Fax
- (203) 672-2801
- Mailing Address
- 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473
- Mailing Phone
- (203) 672-2800
- Mailing Fax
- (203) 672-2801
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-15-2007
- Last Update Date
- 05-31-2012
- Code Navigator
An internist like Family Practice & Internal Medicine, Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500000049 | MEDICAID (05) | CT | |
| ========= | OTHER (01) | CT | TRICARE |
| DG5581 | OTHER (01) | CT | RAILROAD MEDICARE |
| C03810 | MEDICARE PIN (08) | CT |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D1070751
- Facility Type
- Physician Office
- Certificate Effective Date
- July 09, 2023
- Certificate Expiration Date
- July 08, 2025
- Laboratory Director
- FAUSTO PETRUZZIELLO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Family Practice & Internal Medicine, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 0 | 2 | 0 | 9 | 5 | 0 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 0 | 9 | 10 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 0 + 9 + 1 + 0 + 0 + 0 + 24 = 47 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 47 = 3 | 3 | ||||||||
The NPI number 1902095003 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1093856833 | REBECCA JUDE GRILLO P.A. Individual | Physician Assistant (Medical) | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1578607727 | ASSUNTA MARIA SANDOR P.A. Individual | Physician Assistant (Medical) | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1598073348 | RALPH LAUDANO MAURIELLO P.T. Individual | Physical Therapist (Orthopedic) | 52 WASHINGTON AVE NORTH HAVEN, CT 06473 (203) 691-0961 |
| 1083922470 | SYNERGY REHABILITATION LLC Organization | Physical Therapist | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 691-0961 |
| 1487904520 | MR. NIKIT Y SHAH PA-C Individual | Physician Assistant (Medical) | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1063492536 | ANTONIO D.S. LOPEZ M.D. Individual | Internal Medicine | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1679633747 | MS. MEREDITH WALLACE KAZER PHD, APRN-BC Individual | Nurse Practitioner (Adult Health) | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1528460565 | BARBARA BACAL RD Individual | Dietitian, Registered | 52 WASHINGTON AVE NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1316933419 | FAUSTO PETRUZZIELLO MD Individual | Internal Medicine | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1316316474 | KRIEZEL CHARMEL ERSANDO PRESTA PA-C Individual | Physician Assistant | 52 WASHINGTON AVE SUITE 4 NORTH HAVEN, CT 06473 (203) 672-2800 |
| 1841231792 | NORTH HAVEN SURGERY CENTER LLC Organization | Clinic/Center (Ambulatory Surgical) | 52 WASHINGTON AVE STE 1 NORTH HAVEN, CT 06473 (203) 234-7727 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902095003, enumerated in the NPI registry as an "organization" on October 15, 2007
The provider is located at 52 Washington Ave Suite 4 North Haven, Ct 06473 and the phone number is (203) 672-2800
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Medicare, Medicaid, Tricare and Railroad Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 07D1070751 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on October 15, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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