Organization Active NPI

New Haven Neurosurgical Assoc. P.C

  • Neurological Surgery Physician
  • Guilford, CT
National Provider Identifier
1841320108
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NEW HAVEN NEUROSURGICAL ASSOC. P.C
Practice address
1570 Boston Post Rd
Guilford, CT 06437-2567
Phone
(203) 772-4001
Fax
(203) 772-4711
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Phillip S Dickey, M.D.NPI 1194748434
Title
Physician
Phone
(203) 772-4001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1570 Boston Post Rd
Guilford, CT 06437-2567

Mailing address

1570 Boston Post Rd Ste 300
Guilford, CT 06437-2568
Phone (203) 772-4001

Other identifiers 1

IdentifierTypeStateIssuer
004180717MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060201000347 CT Part B Supplier - Clinic/Group Practice 2163436981 Receives reassigned benefits from 1 practitioner
Practice locations: New Haven, CT

National Provider Directory

National Provider Directory

Locations

1570 Boston Post Rd
Guilford, CT 06437
Phone (203) 772-4001

1570 Boston Post Rd
Ste 300
Guilford, CT 06437
Phone (203) 772-4001

60 Temple St
Ste 4C
New Haven, CT 06510
Phone (203) 772-4001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12610/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1841320108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 BOSTON POST RD STE 300",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372568",
            "telephone_number": "203-772-4001",
            "fax_number": "203-772-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 BOSTON POST RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372567",
            "telephone_number": "203-772-4001",
            "fax_number": "203-772-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN NEUROSURGICAL ASSOC. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "203-772-4001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004180717",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.