Individual provider Active NPI

Peter J Gruber, M.D,. PH.D

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • New Haven, CT
National Provider Identifier
1053409458
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
57299 Issued in CT
Practice address
330 Cedar St FL BB2
New Haven, CT 06510
Phone
(610) 888-9455
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 57299 CT Primary

Addresses

Primary practice location

330 Cedar St FL BB2
New Haven, CT 06510

Mailing address

668 Milton Rd Apt a
Rye, NY 10580-3227
Phone (610) 888-9455

Other identifiers 1

IdentifierTypeStateIssuer
1053409458MedicaidUT

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
I20180726002441 CT Practitioner - Cardiac SurgeryPractitioner - Other (Physician) 4082898887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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 Philosophy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57299CTMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2018 Accepting new patients
Yale University CurrentSince Jul 1, 2018 Accepting new patients
Radiology Associates of Children'S Hospital, Inc Past Accepting new patients
University Cardiothoracic-Pediatric Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

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

330 Cedar St
Fl BB2
New Haven, CT 06510
Phone (610) 888-9455

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

Interoperability endpoints

  • Direct secure messaging: pgruber399763@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1053409458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 MILTON RD APT A",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105803227",
            "telephone_number": "610-888-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST FL BB2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "610-888-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D,. PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "57299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053409458",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.