Individual provider Active NPI

Karl Dauphinais, M.D.

  • Internal Medicine Physician
  • Farmington, CT
National Provider Identifier
1548467897
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
045140 Issued in CT
Practice address
21 South Road
Suite 110
Farmington, CT 06032
Phone
(860) 284-4945
Fax
(860) 284-4946
NPI assigned
Jun 29, 2007
Last updated
Feb 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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 045140 CT Primary

Addresses

Primary practice location

21 South Road
Suite 110
Farmington, CT 06032

Mailing address

1245 Farmington Ave
# 226
West Hartford, CT 06107-2667
Phone (860) 470-6630

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
I20070829000071 CT Practitioner - Internal Medicine 9335231810 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045140CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Real Life Medical LLC Internal Medicine CurrentSince Dec 20, 2019 Accepting new patients
Prohealth Physicians PC Internal Medicine CurrentSince Nov 2, 2009 Accepting new patients

Locations

21 South Rd
Ste 110
Farmington, CT 06032
Phone (860) 284-4945

1245 Farmington Ave
#226
West Hartford, CT 06107
Phone (860) 470-6630

1245 Farmington Ave
Ste 226
West Hartford, CT 06107

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: karl.dauphinais.1@20856.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Autumn Lake Healthcare at New BritainNew Britain, CT, CCN 075292 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2015
Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1548467897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 FARMINGTON AVE",
            "address_2": "# 226",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072667",
            "telephone_number": "860-470-6630",
            "fax_number": "862-298-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SOUTH ROAD",
            "address_2": "SUITE 110",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-284-4945",
            "fax_number": "860-284-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUPHINAIS",
        "first_name": "KARL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "045140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.