NPIMap

Individual provider Active NPI

John W Colberg, MD

  • Urology Physician
  • New Haven, CT
National Provider Identifier
1053396341
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036647 Issued in CT
Practice address
800 Howard Ave
Yale Physicians Building 3Rd Floor
New Haven, CT 06519-1369
Phone
(203) 785-2815
Fax
(203) 785-4043
NPI assigned
Dec 9, 2005
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036647 CT Primary

Addresses

Primary practice location

800 Howard Ave
Yale Physicians Building 3Rd Floor
New Haven, CT 06519-1369

Mailing address

PO Box 9805
300 George St 6TH Floor
New Haven, CT 06536-0805

Other identifiers 1

IdentifierTypeStateIssuer
001366477MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050328000662 CT Practitioner - Urology 8426004979 Reassigns benefits to 1 organization
I20220420001930 RI Practitioner - Urology 8426004979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Washington College of Physicians and Surgeons, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 785-4638

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036647CTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Yale University CurrentSince Apr 1, 1998 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Apr 1, 1998 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

800 Howard Ave
Bldg 3RD
New Haven, CT 06519
Phone (203) 785-4176

20 York St
North Haven, CT 06510
Phone (203) 688-2433

99 Hawley Ln
Fl 3
Stratford, CT 06614
Phone (203) 502-4650

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

35 Wells St
Unit 1
Westerly, RI 02891
Phone (401) 596-0550

45 East Ave
Westerly, RI 02891
Phone (401) 596-6000

Interoperability endpoints

  • Direct secure messaging: jcolberg8034@direct.ynhh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1053396341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9805",
            "address_2": "300 GEORGE ST 6TH FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065360805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "YALE PHYSICIANS BUILDING 3RD FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2815",
            "fax_number": "203-785-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERG",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "036647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001366477",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.