Active NPI
Nicolas Andre Perez Palmer, MD
- Psychiatry Physician
- West Haven, CT
National Provider Identifier
1306378955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 69247
- Practice address
- 950 Campbell Ave
West Haven, CT 06516-2770 - Phone
- (203) 932-5711
- NPI assigned
- Apr 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 69247 | CT | Primary |
Addresses
Primary practice location
950 Campbell Ave
West Haven, CT 06516-2770
Mailing address
200 College St Apt 430
New Haven, CT 06510-2450
Phone (787) 245-4479
Other practice location 1
1 Church St Fl 8
New Haven, CT 06510-3313
Phone (203) 764-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69247 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1306378955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 COLLEGE ST APT 430",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065102450",
"telephone_number": "787-245-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "203-932-5711"
}
],
"practiceLocations": [
{
"address_1": "1 Church St Fl 8",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103313",
"country_code": "US",
"telephone_number": "203-764-8100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ PALMER",
"first_name": "NICOLAS",
"middle_name": "ANDRE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-03",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "69247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.