Individual provider Active NPI

Dale Davis Sebastian, MD

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1497068084
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1.052474 Issued in CT
Practice address
34 Park St
New Haven, CT 06519-1109
Phone
(203) 974-7811
NPI assigned
Jul 23, 2010
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1.052474 CT Primary

Addresses

Primary practice location

34 Park St
New Haven, CT 06519-1109

Mailing address

301 George St Ste 901
New Haven, CT 06511-6677
Phone (203) 974-7811

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
I20150227000833 CT Practitioner - Psychiatry 3577889070 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, shared by 11 NPIs, 267 clinicians
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1000 Silver St
Middletown, CT 06457-3940
Phone (860) 262-5000

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

34 Park St
New Haven, CT 06519-1109
Phone (860) 418-6617

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1.052474CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Psychiatry CurrentSince Jan 1, 2024 Accepting new patients
State of Connecticut CurrentSince Jul 1, 2014 Accepting new patients
State of Connecticut CurrentSince Jul 1, 2014 Accepting new patients
Yale University CurrentSince Jan 1, 2024 Accepting new patients
State of Connecticut CurrentSince Sep 10, 2017 Accepting new patients

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Organizations & group practices 5

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 2

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1497068084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GEORGE ST STE 901",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116677",
            "telephone_number": "203-974-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "203-974-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "DALE",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "1.052474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.