Individual provider Active NPI

David James Delucia, MD

  • Internal Medicine Physician
  • Waterbury, CT
National Provider Identifier
1285788786
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
038791 Issued in CT
Practice address
134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507
Phone
(203) 756-7788
Fax
(203) 754-1254
NPI assigned
Jan 22, 2007
Last updated
Jan 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038791 CT Primary

Addresses

Primary practice location

134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507

Mailing address

134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507
Phone (203) 756-7788

Other identifiers 1

IdentifierTypeStateIssuer
1241769MedicaidCT

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
I20120220000330 CT Practitioner - Internal Medicine 0446431530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Warren Alpert Medical School of Brown University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6263

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038791CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Internal Medicine CurrentSince Dec 1, 2019 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

Interoperability endpoints

  • Direct secure messaging: daviddelucia@amggw.allscriptsdirect.net

Organizations & group practices 1

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 5

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1285788786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 202",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-7788",
            "fax_number": "203-754-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 202",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-7788",
            "fax_number": "203-754-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCIA",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1241769",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.