Individual provider Active NPI

Thomas Fernandez, M.D.

  • Child & Adolescent Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1124214226
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
045741 Issued in CT
Practice address
230 South Frontage Road
New Haven, CT 06520-7900
Phone
(203) 785-2559
Fax
(203) 785-7400
NPI assigned
Sep 21, 2007
Last updated
Oct 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 045741 CT
Child & Adolescent Psychiatry Physician 2084P0804X 045741 CT Primary

Addresses

Primary practice location

230 South Frontage Road
New Haven, CT 06520-7900

Mailing address

PO Box 207900
230 South Frontage Road
New Haven, CT 06520-7900
Phone (203) 785-2559

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
I20080609000854 CT Practitioner - Psychiatry 4082784582 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045741CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2012 Accepting new patients
Yale University Psychiatry Current Accepting new patients
Yale University CurrentSince Jul 1, 2012 Accepting new patients
Silver Hill Hospital, Inc CurrentSince Feb 11, 2008 Accepting new patients

Locations

208 Valley Rd
New Canaan, CT 06840
Phone (203) 966-3561

230 S Frontage Rd
New Haven, CT 06519
Phone (203) 737-7129

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: tfernandez3078@direct.ynhh.org

Organizations & group practices 4

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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1124214226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207900",
            "address_2": "230 SOUTH FRONTAGE ROAD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065207900",
            "telephone_number": "203-785-2559",
            "fax_number": "203-785-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 SOUTH FRONTAGE ROAD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065207900",
            "telephone_number": "203-785-2559",
            "fax_number": "203-785-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "045741",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "045741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.