Individual provider Active NPI

Fajar Raza, MD

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1053990622
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
80352 Issued in CT
Practice address
646 George St
New Haven, CT 06511-5322
Phone
(203) 784-8700
Fax
(203) 784-8703
NPI assigned
Apr 2, 2021
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 80352 CT Primary

Addresses

Primary practice location

646 George St
New Haven, CT 06511-5322

Mailing address

646 George St
New Haven, CT 06511-5322
Phone (203) 784-8700

Other names 1

  • N/a N/a Other name

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
I20250614000132 CT Practitioner - Psychiatry 5193236446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Psychiatry CurrentSince Jul 1, 2025 Accepting new patients
Yale University CurrentSince Jul 1, 2025 Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

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

Interoperability endpoints

  • Direct secure messaging: fraza729050@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.

Hospital & facility affiliations 2

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1053990622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 GEORGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115322",
            "telephone_number": "203-784-8700",
            "fax_number": "203-784-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 GEORGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115322",
            "telephone_number": "203-784-8700",
            "fax_number": "203-784-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "FAJAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "80352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.