Individual provider Active NPI

Luis Miguel Anez, PSYD

  • Psychologist
  • New Haven, CT
National Provider Identifier
1306052162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
004527 Issued in CT
Practice address
Connecticut Mental Health Center
34 Park St
New Haven, CT 06519
Phone
(203) 974-7417
Fax
(203) 974-7413
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 004527 CT Primary

Addresses

Primary practice location

Connecticut Mental Health Center
34 Park St
New Haven, CT 06519

Mailing address

Connecticut Mental Health Center 34 Park St
Office of Care Management
New Haven, CT 06519
Phone (203) 974-7417

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000019 CT Practitioner - Clinical Psychologist 8022297456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

34 Park St
New Haven, CT 06519-1109
Phone (860) 418-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004527CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Nov 27, 1998 Accepting new patients
State of Connecticut CurrentSince Nov 27, 1998 Accepting new patients

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306052162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CONNECTICUT MENTAL HEALTH CENTER 34 PARK ST",
            "address_2": "OFFICE OF CARE MANAGEMENT",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONNECTICUT MENTAL HEALTH CENTER",
            "address_2": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANEZ",
        "first_name": "LUIS",
        "middle_name": "MIGUEL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "004527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.