Individual provider Active NPI

Dhara Soni, PA-C

  • Surgical Physician Assistant
  • Greenwich, CT
National Provider Identifier
1487089686
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
003116 Issued in CT
Practice address
5 Perryridge Rd
Greenwich, CT 06830-4608
Phone
(630) 200-2055
NPI assigned
Sep 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 016846 NY
Surgical Physician Assistant 363AS0400X 003116 CT Primary

Addresses

Primary practice location

5 Perryridge Rd
Greenwich, CT 06830-4608

Mailing address

101 Roosevelt Ave
216
Carteret, NJ 07008-2491
Phone (630) 200-2055

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024000206 CT Practitioner - Physician Assistant 2769735620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3116CTMDClinical Social Worker
003116CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Hospital CurrentSince Sep 4, 2018 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

Interoperability endpoints

  • Direct secure messaging: dsoni178554@direct.ynhh.org

Organizations & group practices 2

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1487089686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ROOSEVELT AVE",
            "address_2": "216",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082491",
            "telephone_number": "630-200-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304608",
            "telephone_number": "630-200-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONI",
        "first_name": "DHARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "016846",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.