Individual provider Active NPI

Maria Christina Herrera, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Trumbull, CT
National Provider Identifier
1114374063
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
79541 Issued in CT
Practice address
5520 Park Ave
Trumbull, CT 06611-3463
Phone
(845) 494-2259
NPI assigned
May 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 79541 CT
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 79541 CT Primary

Addresses

Primary practice location

5520 Park Ave
Trumbull, CT 06611-3463

Mailing address

100 Church St S Ste A222
New Haven, CT 06519-1703
Phone (845) 494-2259

Other practice location 1

150 Sargent Dr
New Haven, CT 06511-6100
Phone (845) 494-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220801002024 PA Practitioner - Pediatric Medicine 4789066234 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79541CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Jul 1, 2022 Accepting new patients
Fair Haven Community Health Clinic Inc Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

Interoperability endpoints

  • Direct secure messaging: mherrera699532@direct.ynhh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1114374063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHURCH ST S STE A222",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191703",
            "telephone_number": "845-494-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "845-494-2259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Sargent Dr",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065116100",
            "country_code": "US",
            "telephone_number": "845-494-2259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MARIA",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "79541",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "CT",
            "license": "79541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.