Active NPI
Michael John Dewberry, MD
- Psychiatry Physician
- Manchester, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 049015
- Practice address
- 444 Center St
Manchester, CT 06040-3926 - Phone
- (860) 646-3888
- Fax
- (860) 645-4132
- NPI assigned
- Jul 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 049015 | CT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
444 Center St
Manchester, CT 06040-3926
Mailing address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001490150 | Medicaid | CT |
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
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 92.63 of 100
- Quality
- 75.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.44
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049015 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Hospital | Psychiatry | Current | Accepting new patients |
| Community Health Resources, Inc | Current | Accepting new patients | |
| Community Health Resources, Inc. | Current | Accepting new patients | |
| Hartford Hospital | Current | Accepting new patients | |
| Natchaug Hospital, Inc. | Past | Accepting new patients |
Locations
693 Bloomfield Ave
Bloomfield, CT 06002
Phone (860) 242-8427
153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
444 Center St
Manchester, CT 06040
Phone (860) 646-3888
31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451
2 Waterside Xing
Ste 401
Windsor, CT 06095
995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351
Interoperability endpoints
- michael.dewberry@xdr.hhchealthdirect.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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Windsor, CT
- NPI 1215979810
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- Adult Mental Health Clinic/Center
- Windsor, CT
- NPI 1295800795
-
- Psychiatric Hospital
- Mansfield Center, CT
- NPI 1295811321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486339200000",
"number": "1053574442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 DAY HILL RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951722",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 CENTER ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060403926",
"telephone_number": "860-646-3888",
"fax_number": "860-645-4132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWBERRY",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-07",
"last_updated": "2017-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "049015",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001490150",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.