Maryam Gondal, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

71978 Issued in CT

Practice address

330 Cedar Street
BB 114
New Haven, CT 06510

Phone

(203) 785-4184

NPI assigned

Aug 14, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Nephrology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita New Haven Dialysis Dialysis facility, New Haven, CT, CCN 072507
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
• Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

Merit-based Incentive Payment System (MIPS)

Final score

87.36 of 100Reported as group

Quality

77.36

Promoting interoperability

100

Improvement activities

40

Cost

74.27

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgondal191911@direct.ynhh.org
• Direct secure messaging: mgondal27169@directmcleodehealth.org

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.

• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Yale University

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

  • Dermatology Physician
  • Myrtle Beach, SC
  • NPI 1962449181

  Multi-Specialty

  NPD

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

• Dva Renal Healthcare Inc

  dba New Haven Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Haven, CT
  • NPI 1689640997

  Dialysis facility

  Care Compare affiliation Name & address match
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Greenwich Hospital

  • General Acute Care Hospital
  • Greenwich, CT
  • NPI 1609846088
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1003163593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CEDAR STREET",
            "address_2": "BB 114",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-785-4184",
            "fax_number": "203-785-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR STREET",
            "address_2": "BB 114",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-785-4184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 Farrar Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268747",
            "country_code": "US",
            "telephone_number": "843-347-9487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W 10th street",
            "address_purpose": "LOCATION",
            "city": "indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-656-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDAL",
        "first_name": "MARYAM",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "40627",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "71978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keven Gomez
• Nicole Gomez, MD
• Richard Rafael Gomez, MD
• Brooke Goncalves
• Octavio Goncalves, CRNA
• Julia Martha Gonzalez Engle, MD
• Antonio Gonzalez Fiol
• Pedro Jose Gonzalez Jimenez
• Carolina Gonzalez Lopez, MD
• Estheffy Gonzalez Pantaleon

• Internal Medicine Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.