Individual provider Active NPI

Prakash Kandel, M.D

  • Internal Medicine Physician
  • Wallingford, CT
National Provider Identifier
1255619052
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53059 Issued in CT
Practice address
50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone
(203) 284-2800
NPI assigned
Jul 27, 2011
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15028 RI
Internal Medicine Physician 207R00000X 53059 CT Primary

Addresses

Primary practice location

50 Gaylord Farm Rd
Wallingford, CT 06492-2828

Mailing address

40 Bokum Rd
Old Saybrook, CT 06475-1207

Other practice location 1

164 Summit Avenue Fain Building
Providence, RI 02906-1420
Phone (401) 793-4489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140728000304 CT Practitioner - Internal MedicinePractitioner - Hospitalist 4789800814 Reassigns benefits to 2 organizations
I20150928001836 RI Practitioner - Internal Medicine 4789800814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 679-3553

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53059CTMDInternal Medicine Physician
MD15028RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Apr 2, 2019 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Mar 1, 2025 Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: pkandel63861@direct.ynhh.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1255619052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BOKUM RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922828",
            "telephone_number": "203-284-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Summit Avenue Fain Building",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029061420",
            "country_code": "US",
            "telephone_number": "401-793-4489",
            "fax_number": "401-793-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDEL",
        "first_name": "PRAKASH",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15028",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "53059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.