NPIMap

Individual provider Active NPI

Hazar Dahhan, M.D.

  • Cardiovascular Disease Physician
  • Manchester, CT
National Provider Identifier
1023077609
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
028665 Issued in CT
Practice address
201 Main St
Manchester, CT 06042-3540
Phone
(860) 643-5443
Fax
(860) 643-9399
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 028665 CT Primary

Addresses

Primary practice location

201 Main St
Manchester, CT 06042-3540

Mailing address

201 Main Street
Manchester, CT 06042-3540
Phone (860) 643-5443

Other identifiers 2

IdentifierTypeStateIssuer
001286659MedicaidCT
028665OtherCTSTATE MEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000129 CT Practitioner - Cardiovascular Disease (Cardiology) 7517031206 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

201 Main St
Manchester, CT 06042-3540
Phone (860) 643-5443

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6800

Hospital & facility affiliations

  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028665CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Cardiology Center PC Cardiovascular Disease CurrentSince Nov 11, 2009 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 24, 2011 Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Cardiovascular Disease CurrentSince Jul 24, 2011 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

6 Fieldstone Cmns
Ste D
Tolland, CT 06084
Phone (860) 871-6710

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

Interoperability endpoints

  • Direct secure messaging: hdahhan2390297@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1023077609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MAIN STREET",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423540",
            "telephone_number": "860-643-5443",
            "fax_number": "860-643-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423540",
            "telephone_number": "860-643-5443",
            "fax_number": "860-643-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHHAN",
        "first_name": "HAZAR",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "028665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001286659",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "028665",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.