Individual provider Active NPI

Robert Khalil, MD

  • Child & Adolescent Psychiatry Physician
  • Danbury, CT
National Provider Identifier
1205083359
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
042539 Issued in CT
Practice address
7 Old Sherman Tpke Ste 102
Danbury, CT 06810-4174
Phone
(646) 455-1900
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 42539 CT
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 261467 NY
Child & Adolescent Psychiatry Physician 2084P0804X 042539 CT Primary

Addresses

Primary practice location

7 Old Sherman Tpke Ste 102
Danbury, CT 06810-4174

Mailing address

PO Box 602
65 Redding Rd
Georgetown, CT 06829-0602
Phone (646) 455-1900

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
I20081105000714 CT Practitioner - Psychiatry 1557420551 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42539CTMDBehavioral Neurology & Neuropsychiatry Physician
261467NYMDBehavioral Neurology & Neuropsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William W Backus Hospital CurrentSince Jun 5, 2020 Accepting new patients
The William W Backus Hospital Current Accepting new patients
Windham Community Memorial Hospital, Inc. CurrentSince Jun 5, 2020 Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: robert.khalil@xdr.hhchealthdirect.org

Organizations & group practices 4

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1205083359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602",
            "address_2": "65 REDDING RD",
            "city": "GEORGETOWN",
            "state": "CT",
            "postal_code": "068290602",
            "telephone_number": "646-455-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 OLD SHERMAN TPKE STE 102",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104174",
            "telephone_number": "646-455-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "CT",
            "license": "42539",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NY",
            "license": "261467",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "042539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.