NPIMap

Individual provider Active NPI

Erin Longbrake, MD

  • Neurology Physician
  • North Haven, CT
National Provider Identifier
1285862425
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
55076 Issued in CT
Practice address
6 Devine St
Suite 2B
North Haven, CT 06473-2195
Phone
(203) 287-6100
Fax
(203) 287-6101
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2013005295 MO
Internal Medicine Physician 207R00000X 2013005295 MO
Neurology Physician 2084N0400X 55076 CT Primary

Addresses

Primary practice location

6 Devine St
Suite 2B
North Haven, CT 06473-2195

Mailing address

300 George St
FL 6
New Haven, CT 06511-6624
Phone (203) 785-6610

Other identifiers 1

IdentifierTypeStateIssuer
56740053MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725001943 CT Practitioner - Neurology 4486896156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Ohio State University College of Medicine, 2009
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) 785-4638

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

State licenses

LicenseStateTypeSpecialty
2013005295MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Yale University CurrentSince Jul 1, 2016 Accepting new patients

Locations

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

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

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

6 Devine St
Ste 2B
North Haven, CT 06473
Phone (203) 287-6100

Interoperability endpoints

  • Direct secure messaging: elongbrake345501@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 6

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1285862425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST",
            "address_2": "FL 6",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116624",
            "telephone_number": "203-785-6610",
            "fax_number": "203-785-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DEVINE ST",
            "address_2": "SUITE 2B",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732195",
            "telephone_number": "203-287-6100",
            "fax_number": "203-287-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGBRAKE",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2013005295",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013005295",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "55076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56740053",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.