Jonathan Robert Dale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4398 Issued in CT

Practice address

863 N Main Street Ext Ste 200
Wallingford, CT 06492-2434

Phone

(203) 265-3280

NPI assigned

Feb 28, 2010

Reactivated

Mar 6, 2019

Last updated

Dec 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Comprehensive Orthopedics and Musculoskeletal Care LLCGroup PAC ID 9830097864, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025
• Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.dale@xdr.hhchealthdirect.org

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.

• Comprehensive Orthopedics & Musculoskeletal Care LLC

  • Orthopaedic Surgery Physician
  • Wallingford, CT
  • NPI 1790844330
  Medicare reassignment Care Compare group
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment Care Compare group
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD
• Comprehensive Orthopedics & Musculoskeletal Care LLC

  • Orthopaedic Surgery Physician
  • Southington, CT
  • NPI 1821770025
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  Care Compare affiliation
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1669524187
  Care Compare affiliation

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

{
    "created_epoch": "1267315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1962724260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT STE 200",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-265-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT STE 200",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-265-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-28",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "deactivation_date": "2019-01-21",
        "reactivation_date": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri L Cyr, DR OD
• Maribel Diaz D'Adamo
• Victoria D'Agostino, DMD
• John F D'Amico, D.P.M.
• Michelle Ann Daconto, RDH, BS
• Brandon George Dalena
• Elizabeth Darin, OTR/L
• Christina Verna Dasilva
• Gabrielle Kathryn Daur, CCC-SLP
• Kathryn H Davis

• Physician Assistant in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.