Individual provider Active NPI

Donna Marie Pellerin, M.D.

  • Psychiatry Physician
  • Danbury, CT
National Provider Identifier
1154362879
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042430 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 797-7443
NPI assigned
Jun 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042430 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 797-7443

Other identifiers 4

IdentifierTypeStateIssuer
347500OtherCTMANAGED HEALTH NETWORK
9352243OtherCTPHCS
010042430CT01OtherCTANTHEM
2201115OtherCTCIGNA BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040624000915 CT Practitioner - Psychiatry 6608852454 Reassigns benefits to 3 organizations
I20211221002086 NY Practitioner - Psychiatry 6608852454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

152 W St
Danbury, CT 06810-6361
Phone (203) 791-5140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042430CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Psychiatry CurrentSince Jul 6, 2004 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients
Nuvance Health Medical Practice PC Psychiatry CurrentSince Nov 15, 2021 Accepting new patients
Danbury Hospital CurrentSince Oct 1, 2014 Accepting new patients
Health Quest Medical Practice, PC CurrentSince Nov 15, 2021 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients

Locations

152 West St
Danbury, CT 06810
Phone (203) 791-5120

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154362879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-797-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-797-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERIN",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "042430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "347500",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9352243",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010042430CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2201115",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.