Daren R Anderson, MD
Individual provider Active NPI Internal Medicine Physician · Middletown, CT
NPI 1306843529 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1306843529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036530 (CT)
- Practice address
- 631 Main St
Middletown, CT 06457-2762 - Phone
- (203) 599-5081
- Fax
- (860) 638-6842
- NPI assigned
- Jul 1, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220225001722 | CT | Practitioner - Internal Medicine | 2961725676 | |
| I20220728003036 | CA | Practitioner - Internal Medicine | 2961725676 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036530 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confermed of California PC | Internal Medicine | Current |
Accepting new patients |
| Confermed PC | Internal Medicine | Current |
Accepting new patients |
| Community Econsult Network, Inc. | Past |
Accepting new patients |
Locations
101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172
4600 Campus Dr
Ste 203
Newport Beach, CA 92660
Phone (617) 259-5933
19 Grand St
Middletown, CT 06457
Phone (860) 323-0172
11 Silver St
Unit 856
Middletown, CT 06457
631 Main St
Middletown, CT 06457
Phone (203) 599-5081
Interoperability endpoints
- daren.anderson@confermed.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036530 | CT | Yes |
Addresses
Primary practice location
631 Main St
Middletown, CT 06457-2762
Mailing address
635 Main St
Attn: Credentialing DPT
Middletown, CT 06457-2718
Phone (860) 347-6971
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004236346 | Medicaid | CT |
Other providers in Middletown, CT
- Rachel Ann Amatruda
- Paul Thomas Amble
- Kassidy Nicole Amburgey
- George Robert C Amilo
- And Therapy Collaborative LLC
- Joan M Anderson
- Katherine Anderson
- Andrea B. Maule LLC
- Dylan S Andrews
- Melissa Purisima Andrews
All providers in Middletown, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.