NPIMap

Organization Active NPI

Family and Internal Medicine of Dixwell Avenue

  • Internal Medicine Physician
  • Hamden, CT
National Provider Identifier
1962681684
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
032892 Issued in CT
Legal business name
FAMILY AND INTERNAL MEDICINE OF DIXWELL AVENUE
Practice address
2543 Dixwell Ave
Hamden, CT 06514-1809
Phone
(203) 230-4160
Fax
(203) 230-4169
NPI assigned
Oct 30, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Babu S Kumar, MDNPI 1295721942
Title
Physician
Phone
(203) 230-4160

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
Internal Medicine Physician 207R00000X 032892 CT Primary

Addresses

Primary practice location

2543 Dixwell Ave
Hamden, CT 06514-1809

Mailing address

2543 Dixwell Ave
Hamden, CT 06514-1809
Phone (203) 230-4160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080103000525 CT Part B Supplier - Clinic/Group Practice 8527148550 Receives reassigned benefits from 2 practitioners
Practice locations: Hamden, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0959702Family Practice & Internal Medicine of Dixwell Ave2543 Dixwell Avenue, Hamden, CT 06514Provider-performed microscopyApr 18, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECCCBA

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1962681684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141809",
            "telephone_number": "203-230-4160",
            "fax_number": "203-230-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141809",
            "telephone_number": "203-230-4160",
            "fax_number": "203-230-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND INTERNAL MEDICINE OF DIXWELL AVENUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "BABU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "203-230-4160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "032892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.