Individual provider Active NPI

Dennis Laverne Huebner, M.D.

  • Internal Medicine Physician
  • Naugatuck, CT
National Provider Identifier
1043372568
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21108 Issued in CT
Practice address
305 Church St
Suite #1
Naugatuck, CT 06770-2836
Phone
(203) 729-0200
Fax
(203) 729-8292
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21108 CT Primary

Addresses

Primary practice location

305 Church St
Suite #1
Naugatuck, CT 06770-2836

Mailing address

305 Church St
Suite #1
Naugatuck, CT 06770-2836
Phone (203) 729-0200

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061227000186 CT Practitioner - Internal Medicine 4284634197 Practice locations: Naugatuck, CT; Southburg, CT; Waterbury, CT; Watertown, CT; Woodbury, CT

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21108CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suhradam Medical Practice, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1043372568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 CHURCH ST",
            "address_2": "SUITE #1",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702836",
            "telephone_number": "203-729-0200",
            "fax_number": "203-729-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 CHURCH ST",
            "address_2": "SUITE #1",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702836",
            "telephone_number": "203-729-0200",
            "fax_number": "203-729-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBNER",
        "first_name": "DENNIS",
        "middle_name": "LAVERNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "21108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

Verify at the official NPI Registry.