Individual provider Active NPI

Susan M Dabu Bondoc, MD

  • Anesthesiology Physician
  • New Haven, CT
National Provider Identifier
1922080662
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
037047 Issued in CT
Practice address
20 York St
Ynhh Tompkins Building - 3Rd Floor
New Haven, CT 06510-3220
Phone
(203) 785-2802
Fax
(203) 785-6664
NPI assigned
Nov 17, 2005
Last updated
Jun 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 037047 CT Primary

Addresses

Primary practice location

20 York St
Ynhh Tompkins Building - 3Rd Floor
New Haven, CT 06510-3220

Mailing address

300 George St
6TH Floor
New Haven, CT 06511-6624

Other identifiers 1

IdentifierTypeStateIssuer
001370478MedicaidCT

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
I20100813000838 CT Practitioner - Anesthesiology 6305970203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

6 Devine St
North Haven, CT 06473-2195
Phone (203) 287-6100

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037047CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Anesthesiology CurrentSince Jul 1, 1998 Accepting new patients
Yale University CurrentSince Jul 1, 1998 Accepting new patients
Yale University Past Accepting new patients

Locations

20 York St
Bldg 3RD
New Haven, CT 06510
Phone (203) 785-2802

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: sdabubondoc2870@direct.ynhh.org

Organizations & group practices 3

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 4

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1922080662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST",
            "address_2": "6TH FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YNHH TOMPKINS BUILDING - 3RD FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-2802",
            "fax_number": "203-785-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABU BONDOC",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "037047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001370478",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.