Individual provider Active NPI

Richard J Dean, M.D.

  • Urology Physician
  • New Haven, CT
National Provider Identifier
1124054127
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
016515 Issued in CT
Practice address
330 Orchard St
Suite 164
New Haven, CT 06511-4417
Phone
(203) 789-2222
Fax
(203) 624-3697
NPI assigned
Jun 23, 2006
Last updated
Sep 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 016515 CT Primary

Addresses

Primary practice location

330 Orchard St
Suite 164
New Haven, CT 06511-4417

Mailing address

330 Orchard St
Suite 164
New Haven, CT 06511-4417
Phone (203) 789-2222

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
I20180108001080 CT Order and Referring Only - UrologyPractitioner - Urology 2961499447

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
The Urology Center PC Urology PastSince Apr 12, 2004 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1124054127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST",
            "address_2": "SUITE 164",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114417",
            "telephone_number": "203-789-2222",
            "fax_number": "203-624-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST",
            "address_2": "SUITE 164",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114417",
            "telephone_number": "203-789-2222",
            "fax_number": "203-624-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "016515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.