Individual provider Active NPI

Artem Dyatlov, M.D.

  • Surgery Physician
  • Bridgeport, CT
National Provider Identifier
1316378615
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
64955 Issued in CT
Practice address
2660 Main St Ste 110
Bridgeport, CT 06606-5301
Phone
(203) 332-4744
NPI assigned
Dec 11, 2013
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD462842 PA
Surgery Physician 208600000X 64955 CT Primary

Addresses

Primary practice location

2660 Main St Ste 110
Bridgeport, CT 06606-5301

Mailing address

2660 Main St Ste 110
Bridgeport, CT 06606-5301
Phone (203) 332-4744

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ARTEM.DYATLOV@xdr.hhchealthdirect.org Health Information Exchange (HIE)

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
I20200730001554 CT Practitioner - General Surgery 7416211974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (475) 210-5242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgery CurrentSince Aug 5, 2020 Accepting new patients
Neighborhood Health, Inc. Surgery CurrentSince Aug 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 5, 2020 Accepting new patients

Locations

2660 Main St
Ste 110
Bridgeport, CT 06606
Phone (203) 332-4744

2720 Main St
Ste 1
Bridgeport, CT 06606

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: artem.dyatlov@xdr.hhchealthdirect.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 1

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1316378615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST STE 110",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065301",
            "telephone_number": "203-332-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST STE 110",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065301",
            "telephone_number": "203-332-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYATLOV",
        "first_name": "ARTEM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-11",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD462842",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "64955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ARTEM.DYATLOV@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2660 Main St Ste 110",
            "city": "Bridgeport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "066065301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.