Individual provider Active NPI

Eric I Gentry, MD

  • Pulmonary Disease Physician
  • Fairfield, CT
National Provider Identifier
1134200827
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
033755 Issued in CT
Practice address
501 Kings Hwy E
Suite 204
Fairfield, CT 06825-4867
Phone
(203) 610-6300
Fax
(203) 610-6347
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 033755 CT Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 033755 CT
Internal Medicine Physician 207R00000X 033755 CT

Addresses

Primary practice location

501 Kings Hwy E
Suite 204
Fairfield, CT 06825-4867

Mailing address

501 Kings Hwy E
Suite 204
Fairfield, CT 06825-4867
Phone (203) 610-6300

Other identifiers 1

IdentifierTypeStateIssuer
001337551MedicaidCT

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
I20061130000368 CT Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 5395743298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
State University of Ny Upstate Medical University, 1987
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)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 688-4242

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
033755CTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Internal Medicine CurrentSince Aug 31, 2011 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

1152 Kings Highway Cutoff
Fairfield, CT 06824
Phone (203) 256-5500

501 Kings Hwy E
Ste 204
Fairfield, CT 06825
Phone (203) 281-7000

1055 Post Rd
Fairfield, CT 06824
Phone (203) 254-1055

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

112 Quarry Rd
Ste 150
Trumbull, CT 06611
Phone (203) 385-1166

888 White Plains Rd
Ste 203
Trumbull, CT 06611
Phone (203) 459-0408

Interoperability endpoints

  • Direct secure messaging: egentry6144@direct.ynhh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1134200827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 KINGS HWY E",
            "address_2": "SUITE 204",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254867",
            "telephone_number": "203-610-6300",
            "fax_number": "203-610-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 KINGS HWY E",
            "address_2": "SUITE 204",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254867",
            "telephone_number": "203-610-6300",
            "fax_number": "203-610-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "ERIC",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "033755",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "033755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "033755",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001337551",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.