Individual provider Active NPI

Lynn E Fiellin, MD

  • General Practice Physician
  • New Haven, CT
National Provider Identifier
1063495158
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
037691 Issued in CT
Practice address
800 Howard Ave
Yale Physicians Building
New Haven, CT 06519-1369
Phone
(203) 688-2471
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 037691 CT Primary

Addresses

Primary practice location

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

Mailing address

PO Box 208093
367 Cedar Street
New Haven, CT 06520-8093
Phone (203) 688-9106

Other identifiers 1

IdentifierTypeStateIssuer
001376913MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1063495158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208093",
            "address_2": "367 CEDAR STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208093",
            "telephone_number": "203-688-9106",
            "fax_number": "203-737-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "YALE PHYSICIANS BUILDING",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-688-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELLIN",
        "first_name": "LYNN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "037691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001376913",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.