Individual provider Active NPI

Daniel G. Sica, M.D.

  • Internal Medicine Physician
  • Trumbull, CT
National Provider Identifier
1083668628
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
025730 Issued in CT
Practice address
888 White Plains Rd
Suite 203
Trumbull, CT 06611-4552
Phone
(203) 459-0408
Fax
(203) 459-0410
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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 025730 CT Primary

Addresses

Primary practice location

888 White Plains Rd
Suite 203
Trumbull, CT 06611-4552

Mailing address

888 White Plains Rd
Suite 203
Trumbull, CT 06611-4552
Phone (203) 459-0408

Other identifiers 1

IdentifierTypeStateIssuer
001257302MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025730CTMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1083668628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WHITE PLAINS RD",
            "address_2": "SUITE 203",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114552",
            "telephone_number": "203-459-0408",
            "fax_number": "203-459-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 WHITE PLAINS RD",
            "address_2": "SUITE 203",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114552",
            "telephone_number": "203-459-0408",
            "fax_number": "203-459-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICA",
        "first_name": "DANIEL",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "025730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001257302",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.