Shazi Ali
Individual provider Active NPI Nurse Practitioner · Bridgeport, CT
NPI 1134584535 · NPPES record last updated Nov 27, 2024
Key facts
- NPI
- 1134584535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 6424 (CT)
- Practice address
- 4920 Main St
Bridgeport, CT 06606-1300 - Phone
- (860) 380-5150
- NPI assigned
- Dec 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hartford Healthcare Medical Group Specialists PLLC
Northeast Medical Group Inc
Practice addresses (Care Compare)
1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695
267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000
30 Loeffler Rd
Bloomfield, CT 06002-2256
Phone (860) 380-5150
Hospital & facility affiliations
- All About You Home Care Services
- Bridgeport Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160331000529 | CT | Practitioner - Nurse Practitioner | 5496052730 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6424 | CT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Northeast Medical Group, Inc. | Nurse Practitioner | Current |
Accepting new patients |
| Chronic Care Specialists of NJ PC | Current |
Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current |
Accepting new patients |
Locations
226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394
267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170
4920 Main St
Bridgeport, CT 06606
Phone (203) 371-2986
20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
112 Quarry Rd
Trumbull, CT 06611
Phone (203) 374-1515
Interoperability endpoints
- sali10861@direct.ynhh.org
- shazi.ali@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6424 | CT | Yes |
Addresses
Primary practice location
4920 Main St
Bridgeport, CT 06606-1300
Mailing address
79 Golden Hill St
Trumbull, CT 06611-5010
Phone (203) 339-1635
Other practice location 1
267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000
Other providers in Bridgeport, CT
- Crystal Aldophe
- Lauren Alessandro
- Alan Alex
- Ayah Alharbali
- Imran Yousuf Ali
- Darlene Alicea
- Ivelise Alicea
- Karen Ann Alicea
- Alicia Feller LCSW LLC
- Zaid Mohammad M. Alkhananalka'Abneh
All providers in Bridgeport, CT · Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.