STAMFORD HEALTH MEDICAL GROUP, INC. – General Practice Physician, NPI 1154633980
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for STAMFORD HEALTH MEDICAL GROUP, INC.
ONE OMEGA DRIVE
BUILDING 3, 2ND FLOOR
STAMFORD, CT 069072336
Phone: (203) 276-7447
Fax: (203) 276-4350
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-03-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-05-31 (11 days ago).
Enrollment records
21
Earliest due date
2026-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20101025000743 | O | Clinic/Group Practice | CT | TBD |
| O20200429000712 | O | Clinic/Group Practice | FL | 2026-05-31 |
| O20200430001673 | O | Clinic/Group Practice | WA | 2026-06-30 |
| O20200505001047 | O | Clinic/Group Practice | SC | 2026-06-30 |
| O20200505002115 | O | Clinic/Group Practice | KS | 2026-07-31 |
| O20200507000677 | O | Clinic/Group Practice | GA | 2026-07-31 |
| O20200515000280 | O | Clinic/Group Practice | VA | 2026-08-31 |
| O20200521000557 | O | Clinic/Group Practice | NY | 2026-09-30 |
| O20200811002119 | O | Clinic/Group Practice | CA | 2026-10-31 |
| O20201118002155 | O | Clinic/Group Practice | IL | TBD |
| O20201218000904 | O | Clinic/Group Practice | PA | TBD |
| O20201223000061 | O | Clinic/Group Practice | NC | TBD |
| O20210129001333 | O | Clinic/Group Practice | WI | TBD |
| O20210211001621 | O | Clinic/Group Practice | HI | TBD |
| O20220318001346 | O | Clinic/Group Practice | MI | TBD |
| O20230404000601 | O | Clinic/Group Practice | NV | TBD |
| O20230626001013 | O | Clinic/Group Practice | MA | TBD |
| O20230703000256 | O | Clinic/Group Practice | MO | TBD |
| O20240430001339 | O | Clinic/Group Practice | NM | TBD |
| O20250129000347 | O | Clinic/Group Practice | UT | TBD |
| O20250304001694 | O | Clinic/Group Practice | PR | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 06907)
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