Individual provider Active NPI

Sara Ines Dever, MD

  • Allergy & Immunology Physician
  • Fairfield, CT
National Provider Identifier
1992990535
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
046434 Issued in CT
Practice address
55 Walls Dr Ste 405
Fairfield, CT 06824-5163
Phone
(203) 259-7070
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046434 CT
Allergy & Immunology Physician 207K00000X 046434 CT Primary

Addresses

Primary practice location

55 Walls Dr Ste 405
Fairfield, CT 06824-5163

Mailing address

108 Pierce Blvd
Windsor, CT 06095-1711
Phone (860) 219-9361

Other identifiers 1

IdentifierTypeStateIssuer
001464346MedicaidCT

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
I20081202000693 CT Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 7618038118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Connecticut School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy and Asthma Care of Fairfield County LLCGroup PAC ID 4688579980, 4 clinicians

Practice addresses (Care Compare)

55 Walls Dr
Suite 405
Fairfield, CT 06824-5163
Phone (203) 259-7070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046434CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy and Asthma Care of Fairfield County, LLC Allergy & Immunology CurrentSince Nov 1, 2020 Accepting new patients
MVC CT Past Accepting new patients
Advanced Audiology & Hearing Aid Services Past Accepting new patients

Locations

55 Walls Dr
Ste 105
Fairfield, CT 06824

55 Walls Dr
#405
Fairfield, CT 06824
Phone (203) 259-7070

55 Walls Dr
Ste 405
Fairfield, CT 06824
Phone (203) 259-7070

35 Corporate Dr
Ste 1115
Trumbull, CT 06611
Phone (203) 259-7070

Interoperability endpoints

  • Direct secure messaging: sara.dever@allergyasthmacareoffairfieldco.chartmakerdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1992990535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PIERCE BLVD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951711",
            "telephone_number": "860-219-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WALLS DR STE 405",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245163",
            "telephone_number": "203-259-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVER",
        "first_name": "SARA",
        "middle_name": "INES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "046434",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CT",
            "license": "046434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001464346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.