Individual provider Active NPI

Edward Prior, M.D.

  • Internal Medicine Physician
  • West Haven, CT
National Provider Identifier
1336130293
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
026944 Issued in CT
Practice address
687 Campbell Ave
West Haven, CT 06516-3774
Phone
(203) 932-6481
Fax
(203) 932-4051
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 026944 CT Primary

Addresses

Primary practice location

687 Campbell Ave
West Haven, CT 06516-3774

Mailing address

322 E Main St Ste 1B
Branford, CT 06405-3136
Phone (203) 488-7228

Other identifiers 1

IdentifierTypeStateIssuer
001269449MedicaidCT

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
I20100219000220 CT Practitioner - Internal Medicine 7618011255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Margaret Chustecka Internal Medicine of Greater New HavenGroup PAC ID 3274557152, 30 clinicians

Practice addresses (Care Compare)

1952 Whitney Ave
Hamden, CT 06517-1209
Phone (203) 848-1803

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026944CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Margaret Chustecka Internal Medicine of Greater New Haven Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

831 Boston Post Rd
Milford, CT 06460
Phone (203) 283-8113

1952 Whitney Ave
Ste 3
New Haven, CT 06517
Phone (203) 288-0129

1952 Whitney Ave
New Haven, CT 06517
Phone (203) 553-7626

385 Main St
West Haven, CT 06516
Phone (203) 848-6710

Interoperability endpoints

  • Direct secure messaging: edward.prior@imgnh.eclinicaldirectplus.com

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.

Hospital & facility affiliations 4

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1336130293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E MAIN ST STE 1B",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053136",
            "telephone_number": "203-488-7228",
            "fax_number": "203-932-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163774",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIOR",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "026944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001269449",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.