Lisa M Dunkle, MD

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

030377 Issued in CT

Practice address

12 Richborough Rd
Madison, CT 06443-2530

Phone

(203) 245-1042

Fax

(203) 599-6069

NPI assigned

Nov 26, 2008

Last updated

Sep 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1568617918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RICHBOROUGH RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432530",
            "telephone_number": "203-245-1042",
            "fax_number": "203-599-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RICHBOROUGH RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432530",
            "telephone_number": "203-245-1042",
            "fax_number": "203-599-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLE",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "R6582",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CT",
            "license": "030377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Infectious Diseases Physician in Madison, CT
• Providers in Madison, CT by specialty
• Pediatric Infectious Diseases Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.