Michael Stephen Chase
Individual provider Active NPI Psychiatry Physician · Woodbury, CT
NPI 1053196576 · NPPES record last updated Aug 31, 2023
Key facts
- NPI
- 1053196576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 12299 (CT)
- Practice address
- 15 Woodside Cir
Woodbury, CT 06798-1528 - Phone
- (860) 966-4744
- NPI assigned
- Aug 31, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Jewish Family Services of Greenwich Inc
Practice addresses (Care Compare)
1 Holly Hill LN
Greenwich, CT 06830-6001
67 Holly Hill LN
Greenwich, CT 06830-6072
Phone (203) 622-1881
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240813003475 | CT | Practitioner - Nurse Practitioner | 4981142627 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12299 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jewish Family Services of Greenwich Inc | Current |
Accepting new patients |
Locations
67 Holly Hill Ln
Greenwich, CT 06830
Phone (203) 622-1881
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 12299 | CT | Yes |
Addresses
Primary practice location
15 Woodside Cir
Woodbury, CT 06798-1528
Mailing address
15 Woodside Cir
Woodbury, CT 06798-1528
Phone (860) 966-4474
Other practice location 1
189 Orange St
New Haven, CT 06510-2014
Phone (860) 966-4744
Other providers in Woodbury, CT
- C Young Consulting LLC
- Shirley Jane Campbell
- Olivia Carty
- Kelley Castler
- Judith Mangan Charles
- Amanda Chrostowski
- Rio Comaduran
- Compass Behavioral Health LLC
- Phillip Corbi
- Cornerstone Physical Therapy, LLC
All providers in Woodbury, 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 Aug 31, 2023. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.