Individual provider Active NPI

Jan Philipp Bewersdorf, MD

  • Hematology & Oncology Physician
  • New Haven, CT
National Provider Identifier
1174013601
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
75829 Issued in CT
Practice address
35 Park St
New Haven, CT 06519-1110
Phone
(203) 200-4363
Fax
(203) 200-6385
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 75829 CT Primary

Addresses

Primary practice location

35 Park St
New Haven, CT 06519-1110

Mailing address

333 Cedar St
New Haven, CT 06510-3206
Phone (203) 688-9503

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
I20240701000451 CT Practitioner - Hematology/OncologyPractitioner - Medical Oncology 8224384581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 20, 2024 Accepting new patients
Yale University CurrentSince May 20, 2024 Accepting new patients

Locations

333 Cedar St
New Haven, CT 06510
Phone (203) 432-4771

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

35 Park St
New Haven, CT 06519
Phone (203) 200-2100

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Interoperability endpoints

  • Direct secure messaging: jbewersdorf396839@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 4

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1174013601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-688-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191110",
            "telephone_number": "203-200-4363",
            "fax_number": "203-200-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEWERSDORF",
        "first_name": "JAN PHILIPP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "75829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.