Roger R Ayres, M.D.
Individual provider Active NPI Psychiatry Physician · New Haven, CT
NPI 1013975945 · NPPES record last updated Apr 4, 2022
Key facts
- NPI
- 1013975945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 041613 (CT)
- Practice address
- 915 Ella T Grasso Blvd
New Haven, CT 06519-5516 - Phone
- (203) 349-9400
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6118715 | CT | MD | Addiction Medicine (Preventive Medicine) Physician |
| 041613 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Medical, P.C. | Psychiatry | Current |
Accepting new patients |
Locations
4203 Union Deposit Rd
Harrisburg, PA 17111
Phone (223) 797-7187
2103 Harrison Ave NW
Ste 2
Olympia, WA 98502
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 6118715 | CT | |
| Psychiatry Physician | 2084P0800X | 041613 | CT | Yes |
Addresses
Primary practice location
915 Ella T Grasso Blvd
New Haven, CT 06519-5516
Mailing address
PO Box 3396
Milford, CT 06460-0942
Phone (203) 940-3741
Other practice location 1
177 Post Rd W Ste 5
Westport, CT 06880-4652
Phone (203) 341-0706
Other practice location 2
1170 S State St
Ephrata, PA 17522-2601
Phone (717) 859-8000
Other practice location 3
4020 Lake Worth Rd
Palm Springs, FL 33461-3918
Phone (561) 444-3512
Other providers in New Haven, CT
- Rina Ayepah
- Audrey Ayers
- Oluwaseun Faith Ayoade
- Paola Ayora
- Elizabeth Maria Ayotte
- Bilal Ayub
- Julian Azar
- Marwan Azar
- Ariana Azarbad
- Henny Azmanov
All providers in New Haven, CT · Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.