Individual provider Active NPI

Daniel Paul Stupak, M.D.

  • Gastroenterology Physician
  • Trumbull, CT
National Provider Identifier
1669664314
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
045783 Issued in CT
Practice address
115 Technology Dr Unit B106
Trumbull, CT 06611-6339
Phone
(203) 452-1411
Fax
(203) 452-1412
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 245703 NY
Internal Medicine Physician 207R00000X 045783 CT
Gastroenterology Physician 207RG0100X 045783 CT Primary

Addresses

Primary practice location

115 Technology Dr Unit B106
Trumbull, CT 06611-6339

Mailing address

115 Technology Dr Unit B106
Trumbull, CT 06611-6339
Phone (203) 452-1411

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
I20110524000452 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 2062502586 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Connecticut Gi PLLCGroup PAC ID 9830110758, 243 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

85 Seymour St
Suite 1000
Hartford, CT 06106-5529
Phone (860) 246-2571

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.99 of 100Reported as group
Quality
89.16
Promoting interoperability
100
Improvement activities
40
Cost
78.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy56
Upper gastrointestinal (GI) endoscopy for acid reflux58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045783CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Connecticut Gi PLLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Neighborhood Health, Inc. Internal Medicine CurrentSince Oct 2, 2011 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Dec 1, 2020 Accepting new patients
Litchfield County Gastroenterology Associates, LLC Gastroenterology Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
The New York and Presbyterian Hospital Internal Medicine Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

425 Post Rd
Fairfield, CT 06824
Phone (203) 255-4545

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

115 Technology Dr
Unit B201
Trumbull, CT 06611
Phone (203) 452-1411

115 Technology Dr
Unit B106
Trumbull, CT 06611
Phone (203) 372-6460

Interoperability endpoints

  • Direct secure messaging: daniel.stupak@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1669664314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR UNIT B106",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116339",
            "telephone_number": "203-452-1411",
            "fax_number": "203-452-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR UNIT B106",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116339",
            "telephone_number": "203-452-1411",
            "fax_number": "203-452-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUPAK",
        "first_name": "DANIEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245703",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "045783",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "045783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.