Individual provider Active NPI

Donald Stuart Levine, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Middletown, CT
National Provider Identifier
1215934286
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
022725 Issued in CT
Practice address
80 S Main St
Middletown, CT 06457-3648
Phone
(860) 358-6878
Fax
(860) 358-4652
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52691 MA
Internal Medicine Physician 207R00000X ME54648 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 52691 MA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME54648 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 022725 CT Primary
Internal Medicine Physician 207R00000X 022725 CT

Addresses

Primary practice location

80 S Main St
Middletown, CT 06457-3648

Mailing address

80 S Main St
Middletown, CT 06457-3648
Phone (860) 358-6878

Other identifiers 2

IdentifierTypeStateIssuer
6188346MedicaidMA
9707361MedicaidMA

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
022725CTMDInternal Medicine Physician
ME54648FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Sun Medical Clinic, PC PastSince Aug 16, 2007 Accepting new patients

Organizations & group practices 2

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1215934286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-358-6878",
            "fax_number": "860-358-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-358-6878",
            "fax_number": "860-358-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "DONALD",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "52691",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME54648",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "52691",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME54648",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "022725",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "022725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6188346",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9707361",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.