Individual provider Active NPI

Terrell David Holloway, MD

  • Psychiatry Physician
  • Milford, CT
National Provider Identifier
1306342712
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
70102 Issued in CT
Practice address
472 Wheelers Farms Rd Ste 306
Milford, CT 06461-9109
Phone
(203) 701-9737
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 70102 CT Primary

Addresses

Primary practice location

472 Wheelers Farms Rd Ste 306
Milford, CT 06461-9109

Mailing address

472 Wheelers Farms Rd Ste 306
Milford, CT 06461-9109
Phone (631) 355-3366

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
I20221021001539 CT Practitioner - Psychiatry 3779959309 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Icahn School of Medicine at Mount Sinai, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians
Mood Institute PLLCGroup PAC ID 4082039375, 2 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

472 Wheelers Farms Rd
Suite 306
Milford, CT 06461-9109
Phone (203) 701-9737

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
70102CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut Single Specialty CurrentSince Jun 5, 2023 Accepting new patients
Yale University CurrentSince Jul 1, 2024 Accepting new patients
Yale University Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
Silver Hill Hospital, Inc Single Specialty CurrentSince Sep 1, 2022 Accepting new patients
Mood Institute PLLC Single Specialty CurrentSince Jul 5, 2023 Accepting new patients
Mood Institute PLLC Single Specialty CurrentSince Jul 5, 2023 Accepting new patients
State of Connecticut CurrentSince Jun 5, 2023 Accepting new patients

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

472 Wheelers Farms Rd
Ste 306
Milford, CT 06461
Phone (203) 701-9737

208 Valley Rd
New Canaan, CT 06840
Phone (203) 966-3561

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

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

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

3530 Post Rd
Ste 302
Southport, CT 06890
Phone (203) 701-9737

Interoperability endpoints

  • Direct secure messaging: tholloway397714@direct.ynhh.org

Organizations & group practices 7

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1306342712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 WHEELERS FARMS RD STE 306",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064619109",
            "telephone_number": "631-355-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 WHEELERS FARMS RD STE 306",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064619109",
            "telephone_number": "203-701-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "TERRELL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "70102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.