Individual provider Active NPI

Matthew Dolan, M.D.

  • Emergency Medicine Physician
  • New Haven, CT
National Provider Identifier
1821436494
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
55883 Issued in CT
Practice address
20 York St # T-209
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone
(203) 785-5174
Fax
(203) 785-4580
NPI assigned
Jun 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT
Emergency Medicine Physician 207P00000X 55883 CT Primary

Addresses

Primary practice location

20 York St # T-209
Yale-New Haven Hospital
New Haven, CT 06510-3220

Mailing address

20 York St # T-209
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 785-5174

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
I20170106000862 CT Practitioner - Emergency Medicine 4880906072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Dec 19, 2016 Accepting new patients
Middlesex Hospital CurrentSince Jun 1, 2017 Accepting new patients
Middlesex Hospital CurrentSince Jun 1, 2017 Accepting new patients
Yale University CurrentSince Dec 19, 2016 Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

55 Lock St
New Haven, CT 06511
Phone (203) 432-0076

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

Interoperability endpoints

  • Direct secure messaging: mdolan18016@middlesexhealthprd.direct-ci.com

Organizations & group practices 4

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 1

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": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1821436494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST # T-209",
            "address_2": "YALE-NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-5174",
            "fax_number": "203-785-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST # T-209",
            "address_2": "YALE-NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-5174",
            "fax_number": "203-785-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "55883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.