Active NPI
Monique Misra, MD
- Internal Medicine Physician
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 045313
- Practice address
- 64 Black Rock Ave
Bridgeport, CT 06605-1200 - Phone
- (203) 579-5000
- Fax
- (203) 579-5113
- NPI assigned
- Jul 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 045313 | CT | Primary |
Addresses
Primary practice location
64 Black Rock Ave
Bridgeport, CT 06605-1200
Mailing address
471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 333-6864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045313 | Other | CT | STATE LICENSE 045313 |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000
95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388
Hospital & facility affiliations
- Bridgeport Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045313 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
64 Black Rock Ave
Bridgeport, CT 06605
Phone (203) 579-5000
471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
Interoperability endpoints
- mmisra6932@direct.ynhh.org
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Bridgeport, CT
- NPI 1043278351
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bridgeport, CT
- NPI 1649260845
-
- General Acute Care Hospital
- Bridgeport, CT
- NPI 1992910152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1033319793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 BARNUM AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066082409",
"telephone_number": "203-333-6864",
"fax_number": "203-332-0376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 BLACK ROCK AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051200",
"telephone_number": "203-579-5000",
"fax_number": "203-579-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISRA",
"first_name": "MONIQUE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-20",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "045313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE 045313",
"identifier": "045313",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.