Individual provider Active NPI

Bhupinder Singh Lyall, M.D.

  • Gastroenterology Physician
  • Waterbury, CT
National Provider Identifier
1104874999
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
031310 Issued in CT
Practice address
60 Westwood Ave
Suite 314
Waterbury, CT 06708-2460
Phone
(203) 574-3007
Fax
(203) 573-1739
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 031310 CT Primary

Addresses

Primary practice location

60 Westwood Ave
Suite 314
Waterbury, CT 06708-2460

Mailing address

60 Westwood Ave
Suite 314
Waterbury, CT 06708-2460
Phone (203) 574-3007

Other identifiers 1

IdentifierTypeStateIssuer
001313105MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address blyall43707@direct.stfranciscare.org Direct

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
I20110111000601 CT Practitioner - Gastroenterology 9032308796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Upper gastrointestinal (GI) endoscopy for acid reflux46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031310CTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Digestive Disease Center of CT Gastroenterology Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients

Locations

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

60 Westwood Ave
Ste 314
Waterbury, CT 06708
Phone (203) 574-3007

133 Scovill St
Ste 101
Waterbury, CT 06706
Phone (203) 709-3850

160 Robbins St
Waterbury, CT 06708
Phone (203) 573-7284

Interoperability endpoints

  • Direct secure messaging: blyall2385534@direct.trinity-health.org

Organizations & group practices 3

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 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1104874999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 314",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-574-3007",
            "fax_number": "203-573-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 314",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-574-3007",
            "fax_number": "203-573-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYALL",
        "first_name": "BHUPINDER",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "031310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001313105",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blyall43707@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "60 Westwood Ave",
            "address_2": "SUITE 314",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067082460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.