NPIMap

Individual provider Active NPI

Dennis L Dobkin, M.D.

  • Cardiovascular Disease Physician
  • Waterbury, CT
National Provider Identifier
1902833379
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
022917 Issued in CT
Practice address
455 Chase Pkwy
Waterbury, CT 06708-3352
Phone
(203) 573-1435
Fax
(203) 755-7433
NPI assigned
Jun 28, 2006
Last updated
May 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 022917 CT Primary
Nuclear Cardiology Physician 207UN0901X 022917 CT

Addresses

Primary practice location

455 Chase Pkwy
Waterbury, CT 06708-3352

Mailing address

455 Chase Pkwy
Waterbury, CT 06708-3352
Phone (203) 573-1435

Other identifiers 10

IdentifierTypeStateIssuer
001229178MedicaidCT
010022917CT01OtherCTANTHEM BC & BS
022917OtherCTCONNECTICARE
060039537OtherCTRAILROAD MEDICARE
0R0360OtherCTHEALTH NET OF NORTHEAST
25-40429OtherCTUNITED HEALTHCARE
4127782OtherCTAETNA HEALTH PLANS
P381467OtherCTOXFORD HEALTH PLANS
01022917OtherCTCIGNA HEALTH PLANS
1902833379MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19 Autumn Way
Unionville, CT 06085-1597

525 W Brown Rd
FL 9
Mesa, AZ 85201-3202

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022917CTMDNuclear Cardiology Physician

Organizations & group practices 2

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

Hospital & facility affiliations 12

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1902833379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083352",
            "telephone_number": "203-573-1435",
            "fax_number": "203-755-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083352",
            "telephone_number": "203-573-1435",
            "fax_number": "203-755-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBKIN",
        "first_name": "DENNIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "022917",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CT",
            "license": "022917",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001229178",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "010022917CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "022917",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060039537",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET OF NORTHEAST",
            "identifier": "0R0360",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "25-40429",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLANS",
            "identifier": "4127782",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P381467",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLANS",
            "identifier": "01022917",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902833379",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.