Matthew Robert Dukehart, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

033860 Issued in CT

Practice address

175 West Rd
Suite 200
Ellington, CT 06029-3730

Phone

(860) 375-9122

Fax

(860) 375-9133

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Connecticut Valley General & Vascular Surgical Assoc PC

  • Vascular Surgery Physician
  • Enfield, CT
  • NPI 1841487055
  NPD (past)
• CVGV Surgical Associates, PC.

  • Vascular Surgery Physician
  • Enfield, CT
  • NPI 1841699592

  Surgery

  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1497767461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 SOMERS HILL CIR",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060711927",
            "telephone_number": "860-749-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WEST RD",
            "address_2": "SUITE 200",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293730",
            "telephone_number": "860-375-9122",
            "fax_number": "860-375-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKEHART",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "033860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001338608",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal M Colon, LMFT
• Communication Therapy Services, LLC
• Kelly Conley, PA-C
• Core Speech and Language Therapy LLC
• Kristen Marie Diekmann, M. ED., LMFT
• Loretta Lulu Eckhardt, MSPT
• Ellington Dental Associates, P.C.
• Ellington Obstetrics & Gynecology Associates, P.C.
• Ellington Pediatrics
• Ellington Physical Therapy LLC

• Surgery Physician in Ellington, CT
• Providers in Ellington, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.