Active NPI
Danice Kuruvilla, M.D.
- Pediatrics Physician
- New Haven, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 61700
- Practice address
- 1 Park St
New Haven, CT 06504 - Phone
- (203) 785-4081
- NPI assigned
- May 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 61700 | CT | Primary |
Addresses
Primary practice location
1 Park St
New Haven, CT 06504
Mailing address
1 Park St
New Haven, CT 06504-8901
Other practice location 1
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-2335
Other practice location 2
282 Washington St
Hartford, CT 06106-3322
Phone (860) 837-5506
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dkuruvilla79717@connecticutchildrens.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61700 | CT | MD | Pediatrics Physician |
| N/A | NC | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut Children'S Specialty Group, Inc. | Pediatrics | Current | Accepting new patients |
| Yale University | Current | Accepting new patients | |
| Connecticut Children'S Specialty Group, Inc. | Pediatrics | Current | Accepting new patients |
| Yale University | Pediatrics | Current | Accepting new patients |
Locations
10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
1 Park St
North Haven, CT 06504
Phone (203) 785-4643
Interoperability endpoints
- dkuruvilla79717@connecticutchildrens.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Hartford, CT
- NPI 1669448882
-
- Ophthalmology Physician
- Glastonbury, CT
- NPI 1568056984
Pediatrics
-
- Durable Medical Equipment & Medical Supplies
- Fairfield, CT
- NPI 1548066962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1003295023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065048901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06504",
"telephone_number": "203-785-4081"
}
],
"practiceLocations": [
{
"address_1": "2100 Stantonsburg Rd",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278342818",
"country_code": "US",
"telephone_number": "252-744-2335",
"fax_number": "252-744-3800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "282 Washington St",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061063322",
"country_code": "US",
"telephone_number": "860-837-5506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KURUVILLA",
"first_name": "DANICE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-22",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "61700",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dkuruvilla79717@connecticutchildrens.direct-ci.com",
"affiliation": "N",
"address_1": "282 Washington St",
"city": "Hartford",
"state": "CT",
"country_code": "US",
"postal_code": "061063322",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.