Individual provider Active NPI

Kirithika Mohanathaas, M.D.

  • Internal Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1043695588
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56769 Issued in CT
Practice address
471 Barnum Ave
Bridgeport, CT 06608
Phone
(203) 333-3030
NPI assigned
Jul 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56769 CT Primary

Addresses

Primary practice location

471 Barnum Ave
Bridgeport, CT 06608

Mailing address

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 333-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231117001224 NY Practitioner - Internal Medicine 8325346182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

257 Lafayette Ave
Suffern, NY 10901-4830
Phone 845353560025027

Hospital & facility affiliations

  • Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158
  • Nyack Hospital Hospital, Nyack, NY, CCN 330104
  • Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56769CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients

Locations

60 Dutch Hill Rd
Orangeburg, NY 10962
Phone (845) 359-4770

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

2 Crosfield Ave
Ste 318
West Nyack, NY 10994
Phone (845) 353-5600

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1043695588",
    "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": "203-333-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06608",
            "telephone_number": "203-333-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANATHAAS",
        "first_name": "KIRITHIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "56769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.