Individual provider Active NPI

Rasikh Nailovich Tuktamyshov, M.D.

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1285885855
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50175 Issued in CT
Practice address
1450 Chapel St
New Haven, CT 06511-4405
Phone
(203) 789-3034
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 50175 CT Primary

Addresses

Primary practice location

1450 Chapel St
New Haven, CT 06511-4405

Mailing address

187 Orange St
Apt. 1a
New Haven, CT 06510-2017
Phone (203) 500-9402

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111018000685 CT Practitioner - HospitalistPractitioner - Internal Medicine 9234301169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50175CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince Sep 1, 2012 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Saint Raphael Faculty Physicians Internal Medicine Past Accepting new patients

Locations

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: rtuktamyshov100138@direct.ynhh.org

Organizations & group practices 3

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 2

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": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1285885855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 ORANGE ST",
            "address_2": "APT. 1A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102017",
            "telephone_number": "203-500-9402"
        },
        {
            "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": "203-789-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUKTAMYSHOV",
        "first_name": "RASIKH",
        "middle_name": "NAILOVICH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "50175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.