Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Darrell Sutijono, MD

Individual provider Emergency Medicine Physician · NPI 1508061474

Dr. Darrell Sutijono, MD is an Emergency Medicine in New Haven, Connecticut. Qualified in 2005, 21 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California, Connecticut and New York.

Years since qualifying
21
Licensed in
CA, CT, NY
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

464 Congress Ave Ste 260
New Haven, CT 06519-1361
Phone: (203) 785-3637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 047403 (CT)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 250087-1 (NY)
Emergency Medicine Physician Taxonomy 207P00000X · Licence A106810 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1508061474
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 19, 2007
Last updated in NPPESDecember 15, 2021
Mailing address120 Greenwich St, 9j, New York, NY 10006-1500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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