Individual provider Active NPI

Daniel Kenneth Sunderland, DO

  • Family Medicine Physician
  • West Hartford, CT
National Provider Identifier
1578143863
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77281 Issued in CT
Practice address
41 N Main St Ste 211
West Hartford, CT 06107-1929
Phone
(860) 236-0331
Fax
(860) 263-8697
NPI assigned
Apr 10, 2021
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77281 CT Primary

Addresses

Primary practice location

41 N Main St Ste 211
West Hartford, CT 06107-1929

Mailing address

41 N Main St Ste 211
West Hartford, CT 06107-1929
Phone (860) 236-0331

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
I20240802002764 CT Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 9335686740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collins Medical Associates 2 PCGroup PAC ID 3779486345, 43 clinicians

Practice addresses (Care Compare)

41 N Main St
Suite 211
West Hartford, CT 06107-1929
Phone (860) 236-0331

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Collins Medical Associates 2 PC CurrentSince Jul 1, 2024 Accepting new patients
Collins Medical Associates 2 PC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

95 Woodland St
Fl 1
Hartford, CT 06105
Phone (860) 714-7362

41 N Main St
Ste 211
West Hartford, CT 06107
Phone (860) 236-0331

Interoperability endpoints

  • Direct secure messaging: daniel.sunderland.1@27673.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27673/brand/1/csg/1/fhir/r4

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": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1578143863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 N MAIN ST STE 211",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071929",
            "telephone_number": "860-236-0331",
            "fax_number": "860-263-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 N MAIN ST STE 211",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071929",
            "telephone_number": "860-236-0331",
            "fax_number": "860-263-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERLAND",
        "first_name": "DANIEL",
        "middle_name": "KENNETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "77281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.