Individual provider Active NPI

Abraham Charles Yale, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Fairfield, CT
National Provider Identifier
1063511210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000283 Issued in CT
Practice address
1881 Post Rd
Fairfield, CT 06824-5721
Phone
(203) 255-1036
Fax
(203) 259-3444
NPI assigned
Sep 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000283 CT Primary

Addresses

Primary practice location

1881 Post Rd
Fairfield, CT 06824-5721

Mailing address

1881 Post Rd
Fairfield, CT 06824-5721
Phone (203) 255-1036

Other identifiers 4

IdentifierTypeStateIssuer
030000283CT01OtherCTANTHEM PIN
752951OtherCTUNITED HEALTH PIN
ZS3200OtherCTOXFORD PIN
510840OtherCTAETNA PIN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070918000366 CT Practitioner - Podiatry 3870599079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Podiatrist of Fairfield LLCGroup PAC ID 7618061052, 7 clinicians
Associated Podiatrists of North HavenGroup PAC ID 9830283795, 5 clinicians

Practice addresses (Care Compare)

1881 Post Rd
Fairfield, CT 06824-5721
Phone (203) 255-1036

83 Washington Ave
North Haven, CT 06473-1704
Phone (203) 787-3800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue32
Removal or shaving of skin growth16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000283CTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Podiatrists of North Haven CurrentSince Sep 1, 2007 Accepting new patients
Associated Podiatrist of Fairfield, LLC Foot & Ankle Surgery CurrentSince Sep 1, 2007 Accepting new patients

Locations

1881 Post Rd
Fairfield, CT 06824
Phone (203) 255-1036

12 Village St
North Haven, CT 06473
Phone (203) 777-2044

83 Washington Ave
North Haven, CT 06473
Phone (203) 787-3800

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063511210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245721",
            "telephone_number": "203-255-1036",
            "fax_number": "203-259-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245721",
            "telephone_number": "203-255-1036",
            "fax_number": "203-259-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALE",
        "first_name": "ABRAHAM",
        "middle_name": "CHARLES",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "030000283CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PIN",
            "identifier": "752951",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PIN",
            "identifier": "ZS3200",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "510840",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.