Individual provider Active NPI

Doreen Bibeau Chimblo, APRN

  • Family Nurse Practitioner
  • Stamford, CT
National Provider Identifier
1174610653
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
003416 Issued in CT
Practice address
30 Shelburne Rd
Stamford, CT 06902-3628
Phone
(203) 276-7582
Fax
(203) 276-4022
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 003416 CT Primary

Addresses

Primary practice location

30 Shelburne Rd
Stamford, CT 06902-3628

Mailing address

30 Shelburne Rd
Stamford, CT 06902-3628
Phone (203) 276-7582

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061107000088 CT Practitioner - Nurse Practitioner 0244237188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000

29 Hospital PLZ
Stamford, CT 06902-3602

4 Hospital PLZ
Suite 102
Stamford, CT 06902-3602
Phone (203) 276-2330

5 High Ridge Park
Suite 103
Stamford, CT 06905-1326
Phone (203) 276-4644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.86
Promoting interoperability
99
Improvement activities
40
Cost
71.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3416CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc CurrentSince Apr 1, 2015 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

Interoperability endpoints

  • Direct secure messaging: dchimblo24254@stamfordhealth.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 1

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 1

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1174610653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-7582",
            "fax_number": "203-276-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-7582",
            "fax_number": "203-276-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMBLO",
        "first_name": "DOREEN",
        "middle_name": "BIBEAU",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.