NPIMap

Individual provider Active NPI

Dennis J Kobylarz, M.D.

  • Family Medicine Physician
  • Canaan, CT
National Provider Identifier
1003813965
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
027736 Issued in CT
Practice address
10 Granite Ave.
Canaan, CT 06018-0970
Phone
(860) 824-0753
Fax
(860) 824-4448
NPI assigned
Jul 6, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 027736 CT Primary

Addresses

Primary practice location

10 Granite Ave.
Canaan, CT 06018-0970

Mailing address

PO Box 970
Canaan, CT 06018-0970
Phone (860) 824-0753

Other identifiers 18

IdentifierTypeStateIssuer
001277367MedicaidCT
3003621MedicaidMA
5996764OtherNYGHI
A67899OtherMAHARVARD
A21057OtherMAMEDICARE MA
000000026702OtherMABMC HEALTHNET
RO1115OtherMABLUE CROSS BLUE SHIELD MA
010027736CT01OtherCTBLUE CROSS BLUE SHIEL CT
080001602OtherCTMEDICARE CT
366275OtherAETNA
010017975OtherCTRAILROAD MEDICARE
081142OtherNYMVP
2V5878OtherCTHEALTHNET
P3296700OtherOXFORD
0119144OtherEVERCARE
779997OtherCTCONNECTICARE
054714OtherMATUFTS
13644OtherMAHEALTH NEW ENGLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050926000504 MA Practitioner - Family Practice 6507890845 Reassigns benefits to 1 organization
I20090922000422 CT Practitioner - Family Practice 6507890845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 Granite Ave
Canaan, CT 06018-2174

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
027736CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Programs, Inc. Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Geer Nursing & RehabCanaan, CT, CCN 075202 Skilled nursing facility Corporate Director Jun 28, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1003813965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "CANAAN",
            "state": "CT",
            "postal_code": "060180970",
            "telephone_number": "860-824-0753",
            "fax_number": "860-824-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRANITE AVE.",
            "city": "CANAAN",
            "state": "CT",
            "postal_code": "060180970",
            "telephone_number": "860-824-0753",
            "fax_number": "860-824-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLARZ",
        "first_name": "DENNIS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "027736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001277367",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003621",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5996764",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "A67899",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MA",
            "identifier": "A21057",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000026702",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "RO1115",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIEL CT",
            "identifier": "010027736CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CT",
            "identifier": "080001602",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "366275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010017975",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "081142",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V5878",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3296700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0119144",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "779997",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "054714",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "13644",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canaan, CT

Sources for this page

Verify at the official NPI Registry.