Kismatkumar Detroja, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

044462 Issued in CT

Practice address

1000 Silver Street
Middletown, CT 06457

Phone

(860) 951-4954

NPI assigned

Jul 19, 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 11

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Connecticut

  • Psychiatric Hospital
  • Middletown, CT
  • NPI 1245256247
  Medicare reassignment NPD
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235
  Medicare reassignment NPD
• Windham Community Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Willimantic, CT
  • NPI 1023191467

  Hospitalist

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Connecticut, LLC

  • Internal Medicine Physician
  • Manchester, CT
  • NPI 1558696153
  Medicare reassignment
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718

  Internal Medicine

  NPD
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  NPD
• Eastern Connecticut Medical Professionals Foundation Inc

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1770557712

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1497774657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 TALCOTT RIDGE RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742386",
            "telephone_number": "860-794-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SILVER STREET",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-951-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETROJA",
        "first_name": "KISMATKUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "044462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010044462CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001444629",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "144462",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHN",
            "identifier": "1497774657",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "149777465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "207787971",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "41044914",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7382858",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMN",
            "identifier": "581828",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7382858",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1497774657",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corrina E Desautels
• Janice Desi, PA
• Matthew Desir
• Susan Alessi Desousa, BS MSW
• Emily Despierre, NP
• Robyn Devaughn
• Lauren Marie Devlin, LPC, NCC
• Karen Dexter, LCSW
• Diana E Dash
• Belarmina Dias, LICSW

• Internal Medicine Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.