Active NPI
Myer B Shimelman, MD
- Psychiatry Physician
- New Haven, CT
National Provider Identifier
1073562195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0015578
- Practice address
- 1 Long Wharf Dr
Suite 302
New Haven, CT 06511-5991 - Phone
- (203) 624-5522
- Fax
- (203) 624-4301
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0015578 | CT | Primary |
Addresses
Primary practice location
1 Long Wharf Dr
Suite 302
New Haven, CT 06511-5991
Mailing address
1 Long Wharf Dr
Suite 302
New Haven, CT 06511-5991
Phone (203) 624-5522
Other identifiers 22
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004082286 | Other | CT | MEDICAID APT FOUNDATION INC. |
| NHS125 | Other | OXFORD | |
| 008042339 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 004082260 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 008024427 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 001155787 | Other | CT | MEDICAID DR. SHIMELMAN'S INDIVIDUAL # |
| 004041000 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 008022622 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 010015578CT01 | Other | CT | ANTHEM BLUE CROSS BLUE SH |
| 168637 | Other | MANAGED HEALTH NETWORK | |
| 500000315 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 1548465321 | Other | CT | GROUP NPI |
| 008001325 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 008022626 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 008023170 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 004217099 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 2238345 | Other | CIGNA BEHAVIORAL HEALTH G | |
| 008003745 | Other | CT | MEDICAID APT FOUNDATION INC. |
| 329219 | Other | MAGELLAN BEHAVIORAL HEALT | |
| 0015578 | Other | CIGNA BEHAVIORAL HEALTH | |
| 164472 | Other | VALUE OPTIONS | |
| C01033 | Other | CT | MEDICARE APT FOUNDATION INC. |
Other names 1
- M B Shimelman
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0015578 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1073562195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"address_2": "SUITE 302",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-624-5522",
"fax_number": "203-624-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"address_2": "SUITE 302",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-624-5522",
"fax_number": "203-624-4301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMELMAN",
"first_name": "MYER",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "0015578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "004082286",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "NHS125",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008042339",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "004082260",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008024427",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DR. SHIMELMAN'S INDIVIDUAL #",
"identifier": "001155787",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "004041000",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008022622",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "010015578CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "168637",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "500000315",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1548465321",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008001325",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008022626",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008023170",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "004217099",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH G",
"identifier": "2238345",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APT FOUNDATION INC.",
"identifier": "008003745",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "329219",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "0015578",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "164472",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE APT FOUNDATION INC.",
"identifier": "C01033",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "M",
"last_name": "SHIMELMAN",
"middle_name": "B",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}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 Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.