Individual provider Active NPI

David Riccio, MD

  • Internal Medicine Physician
  • East Haven, CT
National Provider Identifier
1083613509
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
022540 Issued in CT
Practice address
310 Main St
East Haven, CT 06512-2919
Phone
(203) 467-1800
Fax
(203) 468-8343
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 022540 CT Primary

Addresses

Primary practice location

310 Main St
East Haven, CT 06512-2919

Mailing address

9 Washington Ave
2ND Floor
Hamden, CT 06518-3267
Phone (203) 248-3013

Other identifiers 6

IdentifierTypeStateIssuer
110179063OtherCTRAILROAD MEDICARE
010022540CT01OtherCTBLUE CROSS BLUE SHIELD
022540OtherCTCONNECTICARE
2047711OtherCTAETNA
NHP075OtherCTOXFORD
0Q2055OtherCTHEALTH NET

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
I20101005000945 CT Practitioner - Internal Medicine 1052491818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
North Carolina Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022540CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Oct 22, 2012 Accepting new patients

Locations

26 Main St
East Haven, CT 06512
Phone (203) 467-1800

310 Main St
East Haven, CT 06512
Phone (203) 467-1800

9 Washington Ave
Fl 2
Hamden, CT 06518
Phone (860) 704-9153

2416 Whitney Ave
Hamden, CT 06518
Phone (203) 248-4331

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: driccio4384@direct.ynhh.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1083613509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WASHINGTON AVE",
            "address_2": "2ND FLOOR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183267",
            "telephone_number": "203-248-3013",
            "fax_number": "203-248-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-467-1800",
            "fax_number": "203-468-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCIO",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "022540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110179063",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010022540CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "022540",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2047711",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NHP075",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0Q2055",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

Verify at the official NPI Registry.