Jonathan D Levine, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

031481 Issued in CT

Practice address

28 Crescent St
Middletown, CT 06457-3654

Phone

(860) 344-6174

Fax

(860) 344-6062

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

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

Owned or controlled facilities with NPI records 3

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

• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233

  Corporate Director, Corporate Officer

  CMS ownership
• Middlesex Hospital

  • Home Health Agency
  • Middletown, CT
  • NPI 1194781328

  Corporate Director, Corporate Officer

  CMS ownership
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334

  Corporate Officer

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connecticut Pathology Group PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Middletown, CT
  • NPI 1740219625

  Anatomic Pathology & Clinical Pathology, CT

  Medicare reassignment Care Compare group NPD Authorized official

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334

  Hospital

  Care Compare affiliation

Specialty

Pathology

Education

University of Vermont College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Pathology Group, P.C. 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649200064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1590",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065061590",
            "telephone_number": "203-397-8000",
            "fax_number": "203-389-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-344-6174",
            "fax_number": "860-344-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "031481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA#",
            "identifier": "5024698",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE#",
            "identifier": "4832",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS#",
            "identifier": "500HBL066CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE#",
            "identifier": "0004400862",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN#",
            "identifier": "001314814P1",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Lee
• Kimberly Legere-Sharples, MD
• Michelle Leister, LCSW
• Zachary Malcolm Lenane, MD, MPH
• Donald Stuart Levine, M.D.
• Larry B Levine, MD
• Joyce Levis, PHARM. D.
• Bruce E. Levison, LCSW, MSW
• Laurence Kent Levy, DMD
• Robert J. Levy, M.D.

• All providers in Middletown, CT
• Anatomic Pathology & Clinical Pathology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.