Individual provider Active NPI

Jose Guadalupe Mejia, M.D.

  • Emergency Medicine Physician
  • New Haven, CT
National Provider Identifier
1174772420
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
047480 Issued in CT
Practice address
1450 Chapel St
New Haven, CT 06511-4405
Phone
(203) 789-3469
Fax
(203) 867-5287
NPI assigned
Sep 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 047480 CT Primary

Addresses

Primary practice location

1450 Chapel St
New Haven, CT 06511-4405

Mailing address

2800 Main St
Bridgeport, CT 06606-4201
Phone (475) 210-5604

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
I20090706000155 CT Practitioner - Emergency Medicine 2466503370 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (475) 210-5242

Hospital & facility affiliations

  • St Vincent'S Medical Center Hospital, Bridgeport, CT, CCN 070028

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047480CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Dec 1, 2020 Accepting new patients
Emergency Medicine Physicians of New Haven County,LLC Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
Neighborhood Health, Inc. Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
Emergency Medicine Physicians of Fairfield County, LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Locations

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

32 Strawberry Hill Ct
Stamford, CT 06902
Phone (203) 276-2000

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

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

Interoperability endpoints

  • Direct secure messaging: jose.mejia@xdr.hhchealthdirect.org

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 and National Provider Directory roles.

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": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1174772420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "475-210-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3469",
            "fax_number": "203-867-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "JOSE",
        "middle_name": "GUADALUPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "047480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.