Danielle M. Tabaka, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001698 Issued in CT

Practice address

11 Arkona Dr
Higganum, CT 06441-4479

Phone

(860) 554-5021

NPI assigned

Aug 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dtabaka14724@middlesexhealthprd.direct-ci.com

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.

• Middlesex Hospital

  dba Middlesex Hospital dba Middlesex Hospital Physician Services

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Medical

  Medicare reassignment Care Compare group NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Hospitalist Physician
  • New Britain, CT
  • NPI 1063461481
  Medicare reassignment NPD
• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment NPD
• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  Medicare reassignment
• Middlesex Hospital

  dba Middlesex Hospital Homecare and Hospice

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Psychiatric Hospital Unit
  • New Britain, CT
  • NPI 1992867006
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1972596997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ARKONA DR",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414479",
            "telephone_number": "860-554-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ARKONA DR",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414479",
            "telephone_number": "860-554-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAKA",
        "first_name": "DANIELLE",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001698",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "1698",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Russell, LCSW
• Linda H Schroth, M.D.
• Angie Seech, PHD, LPC, NCC
• Erin Sember
• Ronald Soper, RPH
• Lorraine Sullivan Taylor, APRN
• Anna Eleanor Tralli, MSW
• Anja Eunique Tucker, LMT
• Rachel Wides Verinis
• John Webber Jr.

• Medical Physician Assistant in Higganum, CT
• Providers in Higganum, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.