Individual provider Active NPI

Ryan J. Dadasovich, M.D.

  • Internal Medicine Physician
  • Stamford, CT
National Provider Identifier
1639390750
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
048922 Issued in CT
Practice address
2015 W Main St
Stamford, CT 06902-4536
Phone
(203) 863-3671
Fax
(203) 863-4758
NPI assigned
May 2, 2007
Last updated
Dec 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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 048922 CT Primary

Addresses

Primary practice location

2015 W Main St
Stamford, CT 06902-4536

Mailing address

2015 W Main St
Stamford, CT 06902-4536
Phone (203) 863-3671

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
I20101113000011 CT Practitioner - Internal Medicine 1355536541 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

2015 W Main St
Suite 150
Stamford, CT 06902-4536
Phone (203) 863-3671

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048922CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Apr 18, 2012 Accepting new patients
Greenwich Hospital CurrentSince Jan 1, 2014 Accepting new patients
Greenwich Hospital CurrentSince Jan 1, 2014 Accepting new patients
Northeast Medical Group Inc CurrentSince Apr 18, 2012 Accepting new patients
Danbury Hospital Past Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

2015 W Main St
Stamford, CT 06902
Phone (203) 273-4872

2015 W Main St
Ste 150
Stamford, CT 06902
Phone (203) 863-3671

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: rdadasovich5800@direct.ynhh.org

Organizations & group practices 6

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 4

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1639390750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 W MAIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024536",
            "telephone_number": "203-863-3671",
            "fax_number": "203-863-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W MAIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024536",
            "telephone_number": "203-863-3671",
            "fax_number": "203-863-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADASOVICH",
        "first_name": "RYAN",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "048922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.