Chadi Berjaoui, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76411 Issued in CT

Practice address

19 Halls Rd
Old Lyme, CT 06371-1457

Phone

(860) 434-8300

Fax

(860) 865-2388

NPI assigned

Jun 22, 2016

Sex

Male

Sole proprietor

No

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351

  CT

  Medicare reassignment Care Compare group NPD
• Mill Hill Medical Consultants Inc

  • Cardiovascular Disease Physician
  • Greenwich, CT
  • NPI 1396755245
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Rocky Hill, CT
  • NPI 1891726568
  Care Compare affiliation Name & address match
• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879

  Hospital

  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459

  Hospital

  Care Compare affiliation
• Visiting Nurse Association of Southeastern Connecticut

  • Home Health Agency
  • Waterford, CT
  • NPI 1265490940
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500

  Hospital

  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726

  Hospital

  Care Compare affiliation
• LMW Healthcare Inc.

  • General Acute Care Hospital
  • Westerly, RI
  • NPI 1447595368

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Medical Group Inc 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale New Haven Health - Health at Home Southeast Home health agency, Waterford, CT, CCN 077015
• Centerwell Home Health Home health agency, Rocky Hill, CT, CCN 077162
• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Westerly Hospital Hospital, Westerly, RI, CCN 410013

Procedures performed for Medicare patients

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cberjaoui645482@direct.ynhh.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 19, 2024.

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1366893281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711457",
            "telephone_number": "860-434-8300",
            "fax_number": "860-865-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711457",
            "telephone_number": "860-434-8300",
            "fax_number": "860-865-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERJAOUI",
        "first_name": "CHADI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R75735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "57761",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "76411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhoda Asimeng, DO, MS
• At Home Within Counseling LLC
• Gloria Avolio, PSYD
• Angela Farah Ballas, APRN
• Laura E Bauer, PT
• Brian Blair
• Anna Naomi Bleasdale, OTR/L
• Leslie S Bridges Parent, OTR
• Jan Fitzgerald Briscoe
• Mercedes Maria Buckingham

• All providers in Old Lyme, CT
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.