NPIMap

Individual provider Active NPI

Joseph P Deluca, M.D.

  • Internal Medicine Physician
  • Middlebury, CT
National Provider Identifier
1629090071
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036186 Issued in CT
Practice address
1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836
Phone
(203) 758-8107
Fax
(203) 568-2925
NPI assigned
Jul 24, 2006
Last updated
Feb 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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 036186 CT Primary

Addresses

Primary practice location

1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836

Mailing address

1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836
Phone (203) 758-8107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000674 CT Practitioner - Internal Medicine 4688567845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1625 Straits Tpke
Middlebury, CT 06762-1836
Phone (203) 758-8107

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036186CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Naugatuck Valley Computerized Imaging Past Accepting new patients
Diagnostic Imaging of Southbury Past Accepting new patients
Diagnostic Imaging Associates LLC Past Accepting new patients
Alliance Medical Group of Greater Waterbury PC Internal Medicine Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1625 Straits Tpke
Ste 110
Middlebury, CT 06762
Phone (203) 758-8107

Interoperability endpoints

  • Direct secure messaging: josephdeluca@amggw.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1629090071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE #110",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8107",
            "fax_number": "203-568-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE #110",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8107",
            "fax_number": "203-568-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

Verify at the official NPI Registry.