Individual provider Active NPI

Camille Ann Brown, MD

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1043226137
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
049699 Issued in CT
Practice address
789 Howard Ave
Yale Pediatrics, Dana Building
New Haven, CT 06519-1304
Phone
(203) 688-2468
NPI assigned
Jul 31, 2006
Last updated
Apr 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A81946 CA
Pediatrics Physician 208000000X 049699 CT Primary

Addresses

Primary practice location

789 Howard Ave
Yale Pediatrics, Dana Building
New Haven, CT 06519-1304

Mailing address

PO Box 208064
Dept. of Pediatrics, Yale University
New Haven, CT 06520-8064
Phone (203) 688-2468

Other identifiers 1

IdentifierTypeStateIssuer
00A819460MedicaidCA

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
I20161118000385 CT Practitioner - Pediatric Medicine 6608846399 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81946CAMDPediatrics Physician
049699CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Oct 20, 2016 Accepting new patients
Yale University CurrentSince Oct 20, 2016 Accepting new patients

Locations

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: cbrown49104@direct.ynhh.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1043226137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208064",
            "address_2": "DEPT. OF PEDIATRICS, YALE UNIVERSITY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-688-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 HOWARD AVE",
            "address_2": "YALE PEDIATRICS, DANA BUILDING",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191304",
            "telephone_number": "203-688-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAMILLE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A81946",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "049699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A819460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.