Individual provider Active NPI

Royd K. Fukumoto, M.D.

  • Surgery Physician
  • Danbury, CT
National Provider Identifier
1902071988
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A103230 Issued in CA
Practice address
111 Osborne St
Danbury Hospital Medical Arts Center
Danbury, CT 06810-6000
Phone
(203) 739-7131
Fax
(203) 739-1554
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A103230 CA Primary

Addresses

Primary practice location

111 Osborne St
Danbury Hospital Medical Arts Center
Danbury, CT 06810-6000

Mailing address

111 Osborne St
Danbury Hospital Medical Arts Center
Danbury, CT 06810-6000
Phone (203) 739-7131

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
I20090804000487 CT Practitioner - General Surgery 8426117524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)31
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A103230CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Surgery CurrentSince Aug 3, 2009 Accepting new patients

Locations

111 Osborne St
Danbury, CT 06810
Phone (203) 739-7131

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

Organizations & group practices 1

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1902071988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "address_2": "DANBURY HOSPITAL MEDICAL ARTS CENTER",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "address_2": "DANBURY HOSPITAL MEDICAL ARTS CENTER",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUMOTO",
        "first_name": "ROYD",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A103230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.