Hospitals, Hospital Systems, and Group Practices with 30 Or More Physicians Written Report Due by December 31St Annually

Medical Practice Data

Hospitals, Hospital Systems, and Group Practices with 30 or more physicians Written Report due by December 31st annually

Date of Filing ------> Dec. 21, 2015 Full Legal Name of Entity Reporting ------> Stamford Health Integrated Practices, Inc. Type of Provider Reporting (see options below) ------> Group Practice (Hospital, Hospital System, Group Practice)

(1) (2) (3) (4) Is the Group Practice reported owned Description of the nature of the relationship of the Name of Group Practice being reported or affiliated by the Hospital or Hospital or Hospital System to the Group Practice Line Hospital System? 1 Stamford Health Integrated Practices, Inc. Group Practice is a subsidiary of Stamford Hospital Owned by Stamford Hospital 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

Group Practice Reporting Page 1 of 8 Medical Practice Data Physician Name Data

Hospitals, Hospital Systems, and Group Practices with 30 or more physicians Written Report due by December 31st annually

If more than one Group Practice is being reported, please follow the instructions below to add additional tabs. 1 Right click on the the "PhysicianName" tab below 2 Click the "Move or Copy" option 3 Under the heading "Before Sheet:," click on "Business Entity" 4 Click inside the "create a copy" box 5 Click "OK"

Name of Group Practice ------> Stamford Health Integrated Practices, Inc.

(1) (2) (3) Line Physician Name (Last, First) Physician Specialty(s)

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services. 1 Dr. Acosta,Rodrigo Family practice 2 Dr. Alleva,Anthony Internal medicine 3 Dr. Aronow,Elisabeth Obstetrics/gynecology 4 Dr. Asnis,Maria Cecilia C Endocrinology 5 Dr. Babayev, Revekka Nephrology 6 Dr. Barbadimos,Arghiris Physical medicine and rehabilitation 7 Dr. Bendl,Jennifer Family practice 8 Dr. Beger, Eric Rheumatology 9 Dr. Bishop,Jennifer General surgery 10 Dr. Boside, Neil N. Internal medicine 11 Dr. Brown,Eric Y. Nephrology 12 Dr. Caragol,William Radiation oncology 13 Dr. Carbonaro,Salvatore Cardiovascular disease (cardiology) 14 Dr. Chan,Brenda S. Nephrology 15 Dr. Chaudhary,Neeta D General surgery 16 Dr. Cheng,Zandra General surgery 17 Dr. Choi,Joonun Cardiovascular disease (cardiology) 18 Dr. Cipriani,Ralph J. Internal medicine 19 Dr. Ciulla, Melindy Obstetrics/gynecology 20 Dr. Collins,Susan M Internal medicine 21 Dr. Collins-Baine,Amanda C Internal medicine 22 Dr. Costanzo,Joseph Internal medicine 23 Dr. Couture,Carolyn M. Family practice 24 Dr. Cusack,Evelyn Cardiovascular disease (cardiology) 25 Dr. Daunt,Debra A. Internal medicine 26 Dr. De Freese,Marissa A General surgery 27 Dr. Dhruvakumar,Sandhya Cardiac electrophysiology 28 Dr. Di Giovanni,Maria Internal medicine 29 Dr. Dong,Xiang General surgery 30 Dr. D'Onofrio,Gregory Cardiovascular disease (cardiology) 31 Dr. Dorr, James Internal medicine 32 Dr. Douglas, Andrea Neurosurgery 33 Dr. Dowdle,John Orthopedic surgery 34 Dr. Dreyer,Neil P. Internal medicine 35 Dr. Dwyer,Kevin General surgery 36 Dr. Ebright, Deena Family practice 37 Dr. Ebright, Michael Thoracic surgery 38 Dr. Feliciano,Edward Orthopedic surgery 39 Dr. Fennell,Gail Internal medicine 40 Dr. Forman Rose,Robin Internal medicine 41 Dr. Freitas,Marilee Colorectal surgery (proctology) 42 Dr. Fucigna,Carol Obstetrics/gynecology 43 Dr. Gallop,Vernetta D. Internal medicine 44 Dr. Gallousis,Stephen Obstetrics/gynecology 45 Dr. Goldstein,Melissa K Endocrinology 46 Dr. Gordon,Laurie A. Internal medicine 47 Dr. Green,Jeffrey Cardiovascular disease (cardiology) 48 Dr. Gruen,David Radiation oncology 49 Dr. Herbert,Joshua B Internal medicine 50 Dr. Hines,Brian J. Urology 51 Dr. Hines,William H. Nephrology

Group Practice Reporting Page 2 of 8 Physician Name Data Physician Name Data

Hospitals, Hospital Systems, and Group Practices with 30 or more physicians Written Report due by December 31st annually

Name of Group Practice ------> Stamford Health Integrated Practices, Inc.

(1) (2) (3) Line Physician Name (Last, First) Physician Specialty(s)

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services. 52 Dr. Hsi, David Cardiovascular disease (cardiology) 53 Dr. Israel,Shara P. Internal medicine 54 Dr. Jamrozik, Anna Family practice 55 Dr. Juriga, Matthew Podiatry 56 Dr. Kane-Brook,Mary M. Internal medicine 57 Dr. Kernagis,Lily Y. Radiation oncology 58 Dr. King, Valencia Radiation oncology 59 Dr. Kung,Eric Neurology 60 Dr. Kurian,Lisa Internal medicine 61 Dr. Latimer,Clarke Family practice 62 Dr. Leibowitz,Lawrence Family practice 63 Dr. Lindberg,Robert A. Internal medicine 64 Dr. Littlejohn,Charles E. Colorectal surgery (proctology) 65 Dr. Mallozzi,Angelo Family practice 66 Dr. McCalley,Stuart Pulmonary disease 67 Dr. Mehta,Shikha Rheumatology 68 Dr. Miller,Kevin General surgery 69 Dr. Miller,Wayne Cardiovascular disease (cardiology) 70 Dr. Miner,Charles Internal medicine 71 Dr. Misra, Bismruta Endocrinology 72 Dr. Morris,Lynn J. Internal medicine 73 Dr. Mulukutla, Sarah Neurosurgery 74 Dr. Neeson,Francis J Cardiovascular disease (cardiology) 75 Dr. Negus,Philip Internal medicine 76 Dr. Olin,Craig Internal medicine 77 Dr. Ostroff,Allison Geriatric medicine 78 Dr. Papa,Joey General surgery 79 Dr. Parnes,Allyson Radiation oncology, Rheumatology 80 Dr. Pass,Helen A. General surgery 81 Dr. Plansky,Robert L. Internal medicine 82 Dr. Popot,Janine Obstetrics/gynecology 83 Dr. Resor,Louise Neurology 84 Dr. Rose, Kamilah Family practice 85 Dr. Rosenberg,Remi Internal medicine 86 Dr. Rosenstein,Charles C. Neurosurgery 87 Dr. Sandhu, Katherine Urology 88 Dr. Schuster,Edward Cardiovascular disease (cardiology) 89 Dr. Shah,Asha K. Infectious disease 90 Dr. Siegel, Brianna Internal medicine 91 Dr. Slutsky,Richard M. Internal medicine 92 Dr. Sparks, Maura Family practice 93 Dr. Stoneburg-Coca,Sara Obstetrics/gynecology 94 Dr. Streett,Linda S. Infectious disease 95 Dr. Troy,Cathrine L. Internal medicine 96 Dr. Tuluca,Inga Internal medicine 97 Dr. Turk,Russell Obstetrics/gynecology 98 Dr. Vadel,Shira B. Internal medicine 99 Dr. VanBeek,Corinne Orthopedic surgery 100 Dr. Vietorisz,Tomas J. Internal medicine 101 Dr. Vinnick,Leonard Internal medicine 102 Dr. Williams, Ann Family practice

Group Practice Reporting Page 3 of 8 Physician Name Data Physician Name Data

Hospitals, Hospital Systems, and Group Practices with 30 or more physicians Written Report due by December 31st annually

Name of Group Practice ------> Stamford Health Integrated Practices, Inc.

(1) (2) (3) Line Physician Name (Last, First) Physician Specialty(s)

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services. 103 Dr. Wong,Andrew C Internal medicine 104 Dr. Xistris,Evangelos Neurology 105 Dr. Yu,Lu Family practice 106 Dr. Zafar,Shahzad Colorectal surgery (proctology) 107 Dr. Zucker,Michael D. Internal medicine 108 Dr. Engel, Murray Neurology, Pediatric medicine 109 Dr. Fryer, Robert Neurology, Pediatric medicine 110 Dr. Stone, Michael General surgery 111 Dr. Madhoun, Maher Internal medicine 112 Dr. Parry, Michael Infectious disease 113 Dr. Corvaya, Nicola Cardiovascular disease (cardiology)

Group Practice Reporting Page 4 of 8 Physician Name Data Business Entity Data

Hospitals, Hospital Systems and Group Practices with 30 or more physicians Written Report due by December 31st annually

If more than one Group Practice is being reported, please follow the instructions below to add additional tabs. 1 Right click on the the "BusinessEntity" tab below 2 Click the "Move or Copy" option 3 Under the heading "Before Sheet:," click on "(move to end)" 4 Click inside the "create a copy" box 5 Click "OK"

(1) (2) (3) (4) (5) (6) Primary Service Area as defined in Section Name and address of each Business Entity that provides Line Name and address of Group Practice Location 1(11) of PA 14-168 services as part of the Group Practice Description of services at this location

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services.

06902, 06905,06820,06903,06840,06830,06907, GREENWICH Connecticut Spine Institute, Greenwich Neurosurgery 06906, 06897,06831,06851,06854,06901 1 Stamford Health Integrated Practices, Inc. 25 Valley Drive Greenwich, CT 06831 Neurosurgery 06902,06905,06820,06903,06840,06830,06907, Fairfield County Diabetes & Endocrinology - Stamford STAMFORD 2 Stamford Health Integrated Practices, Inc. 06906,06897,06901,06831,06851 292 Long Ridge Road Stamford, CT 06902 Endocrinology 06902,06905,06903,06820,06840,06907, Fairfield County Gastroenterology WILTON 3 Stamford Health Integrated Practices, Inc. 06906,069897,06851 195 Danbury Road Wilton, CT 06987 Gastroenterology Fairfield County Neurology 06902,06905,06820,06903,06840,06830,06907, STAMFORD 166 West Broad Street Suite 203 06906,06897,06851,06831,06901,06854 4 Stamford Health Integrated Practices, Inc. Stamford, CT 06820 Neurology 06902,06905,06820,06903,06840,06830, Fairfield County Obstetrics & Gynecology STAMFORD 5 Stamford Health Integrated Practices, Inc. 06907,06906,06897,06851,06831 292 Long Ridge Road Stamford, CT 06902 Obstetrics/gynecology 06902,06905,06820,06840,06903,06830, Fairfield County Obstetrics & Gynecology - New Canaan NEW CANAAN 6 Stamford Health Integrated Practices, Inc. 06851,06831,06854 161 Cherry Street New Canaan, CT 06840 Obstetrics/gynecology 06902,06905,06820,06903,06840,06830, Fairfield County Obstetrics & Gynecology - Wilton WILTON 7 Stamford Health Integrated Practices, Inc. 06907,06906,06897,06851,06831,06854 396 Danbury Road Wilton, CT 06897 Obstetrics/gynecology 06902,06905,06820,06903,06840,06830, STAMFORD Fairfield County Pediatric Neurology 06907,06906,06897,06851,06831,06854 8 Stamford Health Integrated Practices, Inc. 32 Strawberry Hill Court 4th Floor, Suite 7 Stamford, CT 06902 Neurology Fairfield County Personal Medicine 06902,06905,06820,06903,06840,06830, STAMFORD 5 High Ridge Park, Suite 103, Stamford, CT 06905 06907,06906,06897,06851,06831 9 Stamford Health Integrated Practices, Inc. Internal medicine 06902,06905,06820,06840,06903,06830, Fairfield County Primary Care - New Canaan NEW CANAAN 10 Stamford Health Integrated Practices, Inc. 06907,06906,06897,06851,06831,06854 36 Grove Street New Canaan, CT 06840 Family practice Fairfield County Primary Care - Wilton 06902,06905,06820,06903,06840,06897, WILTON 396 Danbury Road, Wilton, CT 06897 06830,06907,06906,06851,06854,06831 11 Stamford Health Integrated Practices, Inc. Internal medicine 06902,06905,06820,06903,06840,06830,06907, STAMFORD Fairfield County Surgical Specialists - Breast Surgery 06906,06897,0685106831,06854,06901 12 Stamford Health Integrated Practices, Inc. 32 Strawberry Hill Court 4th Floor, Suite 8 Stamford, CT 06902 General surgery Fairfield County Surgical Specialists - Colon & Rectal Surgery 70 06902,06905,06820,06903,06840,06830,06907, STAMFORD Mill River Street Suite LL1 Stamford, CT 06902 06906,06897,06831,06851,06854,06901 13 Stamford Health Integrated Practices, Inc. Colorectal surgery (proctology) 06902,06905,06820,06903,06840,06830,06907, Fairfield County Surgical Specialists, General Surgery - Darien DARIEN 14 Stamford Health Integrated Practices, Inc. 06906,06897,06851,06831 1500 Post Road 2nd Floor Darien, CT 06820 General surgery Fairfield County Surgical Specialists 06902,06905,06820,06903,06840,06830,06907, STAMFORD General & Trauma Surgery - Stamford 06906,06897,06851,06831 15 Stamford Health Integrated Practices, Inc. 1351 Washington Boulevard 6th Floor Stamford, CT 06902 General surgery

Group Practice Reporting Page 5 of 8 Business Entity Data Business Entity Data

Hospitals, Hospital Systems and Group Practices with 30 or more physicians Written Report due by December 31st annually

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services.

06902,06905,06820,06903,06840,06830,06907, Fairfield County Surgical Specialists - Neurosurgery STAMFORD 06906,06897,06851,06831,06854 1 Blachley Road, Chelsea Piers 2nd Floor Stamford, CT 06902 16 Stamford Health Integrated Practices, Inc. General surgery Fairfield County Surgical Specialists 06902,06905,06903,06820,06840,06830,06907, Urogynecology & Pelvic Surgery - Stamford STAMFORD 06906,06897,06831,06851,06901 292 Long Ridge Road Stamford, CT 06902 17 Stamford Health Integrated Practices, Inc. Urology 06902,06905,06820,06903,06830,06840,06831, Greenwich Medical Group GREENWICH 18 Stamford Health Integrated Practices, Inc. 06907,06906,06897,06901 75 Holly Hill Lane Greenwich, CT 06830 Internal medicine, Pulmonary disease, Cardiovascular disease (cardiology), Geriatric medicine 06902,06820,06905,06903,06840,06830,06907, Internal Medicine Associates of Darien DARIEN 19 Stamford Health Integrated Practices, Inc. 06906,06897,06851,06854,06831 1500 Boston Post Road 1st Fl Darien, CT 06820 Internal medicine 06902,06905,06820,06903,06840,06830,06907, STAMFORD Medical Associates of Stamford 06906,06901,06897,06851,06831 20 Stamford Health Integrated Practices, Inc. 292 Long Ridge Road Stamford, CT 06902 Internal medicine Norwalk Family Practice 06902,06905,06820,06903,06840,06830,06907, NORWALK 69 East Avenue 06906,06897,06851 21 Stamford Health Integrated Practices, Inc. Norwalk, CT 06851 Family practice Prime Care Medical 06902,06905,06820,06903,06840,06830,06907, STAMFORD 292 Long Ridge Road Stamford, CT 06902 06906,06901,06897,06851,06831 22 Stamford Health Integrated Practices, Inc. Internal medicine Prime Care Medical 06902,06905,06820,06903,06840,06830,06907, STAMFORD 51 Schuyler Ave 06906,06897,06851,06831,06901 23 Stamford Health Integrated Practices, Inc. Stamford, CT 06902 Internal medicine 06902,06905,06903,06820,06840,06830,06907, Prime Care Medical STAMFORD 24 Stamford Health Integrated Practices, Inc. 06906,06897,06851,06831,06854 555 Newfield Avenue Stamford, CT 06905 Internal medicine Riverside Obstetrics & Gynecology 06902,06905,06820,06903,06840,06830,06907, RIVERSIDE 1200 East Putnam Avenue Riverside, CT 06878 06831,06897,06851 25 Stamford Health Integrated Practices, Inc. Obstetrics/gynecology 06902,06905,06903,06820,06840,06830,06907, Riverside Primary Care RIVERSIDE 26 Stamford Health Integrated Practices, Inc. 06906,06897,06851,06831,06854 1200 East Putnam Avenue, Riverside, CT 06878 Internal medicine 06902,06820,06905,06903,06840,06830,06907, Robert A. Lindberg, MD DARIEN 27 Stamford Health Integrated Practices, Inc. 06906,06897,06851 1500 Boston Post Road Darien, CT 06820 Internal medicine 06902,06905,06820,06903,06840,06907,06906, STAMFORD Stamford Family Practice 06830,06901,06851,06854 28 Stamford Health Integrated Practices, Inc. 32 Strawberry Hill Court 4th Floor, Suite 6 Stamford, CT 06902 Internal medicine Stamford Hospital Cardiology - Tully Health Center, Stamford 06902,06905,06820,06903,06840,06830,06907, STAMFORD 32 Strawberry Hill Court 2nd Floor 06906,06897,06851,06831,06901 29 Stamford Health Integrated Practices, Inc. Stamford, CT 06902 Cardiovascular disease (cardiology), Cardiac electrophysiology

Group Practice Reporting Page 6 of 8 Business Entity Data Business Entity Data

Hospitals, Hospital Systems and Group Practices with 30 or more physicians Written Report due by December 31st annually

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services.

Stamford Infectious Diseases 06902,06905,06820,06903,06840,06830,06907, 166 West Broad Street Suite 202 STAMFORD 06906,06897,06851,06831,06854 Stamford, CT 06902 30 Stamford Health Integrated Practices, Inc. Infectious disease 06902,06905,06820,06903,06840,06830,06907 Stamford Nephrology STAMFORD 31 Stamford Health Integrated Practices, Inc. ,06906,06897,06831,06851,06901 30 Commerce Road Stamford, CT 06902 Nephrology 06902,06905,06820,06903,06840,06830,06907, The Heart Physicians - Darien DARIEN 32 Stamford Health Integrated Practices, Inc. 06906,06897,06851 1500 Post Road 2nd Floor Darien, CT 06820 Cardiovascular disease (cardiology) The Heart Physicians - Stamford 06902,06905,06820,06903,06840,06907,06830, STAMFORD 80 Mill River Street Suite 1400 06906,06901,06897,06851,06854 33 Stamford Health Integrated Practices, Inc. Stamford, CT 06902 Cardiovascular disease (cardiology)

06902,06905,06903,06820,06840,06830,06907, Thoracic Surgery STAMFORD 06906 166 West Broad Street Suite 104 34 Stamford Health Integrated Practices, Inc. Stamford, CT 06902 Thoracic surgery 06902,06905,06903,06906,06907,06901,06840,06820, 06807,06830,06854,06880,06878,06824,06877,06851, 06850,06870,06825,06831,06897,06605,10590,10573, 06911,06883,10576,06896,06470,06615,33483,10952, 10589,06478,10528,06461,10577,06601,10591,06405, 06468,06606,10533,06610,06482,06611,10580,06418, 06512,06876,10605,10032,29941,10506,10512,10465, 28374,10710,10553,02642,11735,06483,33487,06484, 10597,06488,11021,06492,13088,06498,32940,06502, 34202,06511,10579,0647,10658,06513,06473,06514, 11372,06515,12569,06516,20015,06518,29582,06524, STAMFORD 33195,06525,34103,02666,10543,06604,10570,02813, 01560,02891,10604,06607,10705,06608,10805,02906, 10970,03102,11209,06612,11530,06614,12533,03254, 12590,06680,18411,06704,20854,06705,29223,06706, 06475,06708,33040,06712,33455,06750,33706,06757, 34119,06770,37215,06776,10550,06784,10562,06786, 06497,06795,10583,06798,10595,06801,10601,06804, 10606,03257,10703,06810,10708,06811,10803,06812, 10918,03287,10956,03753,10989,03854,11105,04260, 11357,05059,11415,06836,11577,05477,12524,06001, Womans Imaging - Tully Health Center 12549,06019,12577,06852,12808,06853,17050,06032, 32 Strawberry Hill Court 2nd Fl. Stamford, CT 06902 35 Stamford Health Integrated Practices, Inc. 19046,06855,20111,06856 Diagnostic radiology

Group Practice Reporting Page 7 of 8 Business Entity Data Business Entity Data

Hospitals, Hospital Systems and Group Practices with 30 or more physicians Written Report due by December 31st annually

When user clicks into a cell below, a dropdown box appears allowing the user to enter multiple services. Users must select one service at a time when entering services.

06820,06902,06840,06897,06903,06851,06854,06850, 06853,06905,06877,06907,06824,06906,06605,10576, 06880,06614,06830,06825,06855,06615,06883,06801, 10528,06807,06811,06890,10022,10970,10573,06518, 34275,06604,10509,06405,10605,06606,12582,06607, 86404,06610,10466,06611,10549,06612,10590,06413, 10710,06415,11937,06708,06762,10017,06759,43017, 06710,33936,10040,06770,10501,06776,10536,06779, 10560,06443,,10580,06802,10601,06804,10708,06451, 10803,06810,11217,06460,12561,06812,18704,02474, 34135,06370,34996,06468,60047,06470,06903,06906, 06907,06901,06840,06820,06807,06830,06854,06880, DARIEN 06878,06824,06877,06851,06850,06870,05725,006831 ,06897,06605,10590,10573,06911,06883,10576,06896, 06470,06615,033483,10952,10589,0678,10528,06461, 10577,06601,10591,06405,06468,06606,10533,06610, 06482,06611,10580,06418,06512,06876,10605,100322 2941,10506,10512,10465,28374,10710,10553,02642,1 1735,06483,33487,06484,10597,06488,11021,06492,1 3088,06498,32940,06502,34202,06511,10579,02647,1 0658,06513,06473,06514,11372,06515,12569,06516,2 0015,0651829582,06524,33195,06525,34103,02666,10 543,06604,101570,02813,01560,02891,10604,06607,1 0705,06608,10802,0290610970,03102,11209,06612,11 35 Stamford Health Integrated Practices, Inc. 530,06614 Womans Imaging - Darien Diagnostic radiology 06902,06905,06820,06903,06840,06830,06907,06 Premier Medical Group-Chelsea Piers One Blanchley Road STAMFORD 36 Stamford Health Integrated Practices, Inc. 906,06901,06851,06897,06831 Stamford, CT 06902 Orthopedic surgery, Podiatry

06905,06840,06830,06897,06854,06901,06878 Urogynecology - Bridgeport 276 37 Stamford Health Integrated Practices, Inc. BRIDGEPORT French Street, Bridgeport, CT 06606 Obstetrics/gynecology

Group Practice Reporting Page 8 of 8 Business Entity Data