Individual provider Active NPI

Dylan J Plante, APRN

  • Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1437793171
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8652 Issued in CT
Practice address
160 Robbins Street
Waterbury, CT 06708-2652
Phone
(203) 755-2999
NPI assigned
Nov 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 8652 CT Primary

Addresses

Primary practice location

160 Robbins Street
Waterbury, CT 06708-2652

Mailing address

160 Robbins Street
Waterbury, CT 06708-2652
Phone (203) 755-2999

Other practice location 1

1 Pomperaug Office Park # 201
Southbury, CT 06488-2295
Phone (203) 755-2999

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8652CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Assoc of Conn PC Single Specialty Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1437793171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ROBBINS STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082652",
            "telephone_number": "203-755-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ROBBINS STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082652",
            "telephone_number": "203-755-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Pomperaug Office Park # 201",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064882295",
            "country_code": "US",
            "telephone_number": "203-755-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLANTE",
        "first_name": "DYLAN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.