Emmanuelle M Clerisme-Beaty, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

42998 Issued in CT

Practice address

12 Night Hawk LN
Sandy Hook, CT 06482-1591

Phone

(203) 417-0714

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1215073671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NIGHT HAWK LN",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NIGHT HAWK LN",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821591",
            "telephone_number": "203-417-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERISME-BEATY",
        "first_name": "EMMANUELLE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "42998",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "D0066621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Caires
• Kathleen Carter
• Jennifer Casey, LCSW
• Marie-Alana Cassullo Lachance
• Elia B Clapis, LCSW
• Jesse Cohen, MD
• Rebecca M Cohen, MSW, LCSW
• Connecticut Acupuncture Center
• Christine K. Coyle, LPC
• Wendy H. Davenson, LMFT, LADC

• Pulmonary Disease Physician in Sandy Hook, CT
• Providers in Sandy Hook, CT by specialty
• Pulmonary Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.