Individual provider Active NPI

Raymond L D'Amato, M.D.

  • Internal Medicine Physician
  • Cromwell, CT
National Provider Identifier
1477555787
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
017716 Issued in CT
Practice address
136 Berlin Rd
Suite 102
Cromwell, CT 06416-2627
Phone
(860) 635-2810
Fax
(860) 632-2352
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 017716 CT Primary

Addresses

Primary practice location

136 Berlin Rd
Suite 102
Cromwell, CT 06416-2627

Mailing address

300 Kensington Ave
New Britain, CT 06051-3916
Phone (860) 224-6200

Other identifiers 9

IdentifierTypeStateIssuer
01217716OtherCTCIGNA ID
060916784009OtherCTTRICARE HNFS ID
P369835OtherCTOXFORD PROVIDER ID
060078OtherCTHEALTH NET ID
010017716CT02OtherCTBCBS COMMERCIAL N BCFP ID
050843OtherCTCONNECTICARE ID
1255448155OtherCTGHMC GRP NPI ID
501435OtherCTAETNA PROVIDER ID
912611OtherCTHEALTH NET REFERRAL ID

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017716CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC 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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477555787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KENSINGTON AVE",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060513916",
            "telephone_number": "860-224-6200",
            "fax_number": "860-224-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "address_2": "SUITE 102",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-635-2810",
            "fax_number": "860-632-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMATO",
        "first_name": "RAYMOND",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "017716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "01217716",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE HNFS ID",
            "identifier": "060916784009",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "P369835",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET ID",
            "identifier": "060078",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS COMMERCIAL N BCFP ID",
            "identifier": "010017716CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE ID",
            "identifier": "050843",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMC GRP NPI ID",
            "identifier": "1255448155",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "501435",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET REFERRAL ID",
            "identifier": "912611",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.