Ann R Datunashvili, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · New Haven, CT
NPI 1376544932 · NPPES record last updated Mar 24, 2017
Key facts
- NPI
- 1376544932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- 039938 (CT)
- Practice address
- 874 Howard Ave
New Haven, CT 06519-1106 - Phone
- (203) 688-8200
- Fax
- (203) 688-8204
- NPI assigned
- Aug 4, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Geriatric Medicine
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Medical Group Inc
Practice addresses (Care Compare)
88 Notch Hill Rd
North Branford, CT 06471-1846
Phone (203) 688-8200
95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388
Hospital & facility affiliations
- Masters in Home Care, LLC
- Yale New Haven Health - Health at Home
- Connecticut Hospice Inc, the
- Home Care Plus, Inc
- Yale-New Haven Hospital
- Whitney Center
- Evergreen Woods
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040520000919 | CT | Practitioner - Geriatric Medicine |
2264423078 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039938 | CT | MD | Geriatric Medicine (Internal Medicine) Physician |
Interoperability endpoints
- adatunashvili5814@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 039938 | CT | Yes |
Addresses
Primary practice location
874 Howard Ave
New Haven, CT 06519-1106
Mailing address
874 Howard Ave
New Haven, CT 06519-1106
Phone (203) 688-8200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061561581 | Other | CT | HEALTH CT |
| P3307906 | Other | CT | OXFORD |
| 2V6380 | Other | CT | HEALTH NET |
| 367593 | Other | CT | WELLCARE OF CT |
| P00132026 | Other | CT | RAIL ROAD MEDICARE |
| 039938 | Other | CT | CONNECTICARE |
| 010039938CT01 | Other | CT | ANTHEM BC/BS |
| 061561581 | Other | CT | UNITED HEALTHCARE |
| 3621604 | Other | CT | AETNA |
| 061561581 | Other | CT | CIGNA |
| 001399387 | Medicaid | CT |
Other providers in New Haven, CT
- Meir Dashevsky
- Susan Dasilva
- Shilpa Dass
- Yesh Datar
- Rupak Datta
- Bailey Daum
- Christine Dauser
- Akanksha Dave
- Amisha Dave
- Elizabeth Kunnecke Davenport
All providers in New Haven, CT · Geriatric Medicine (Internal Medicine) Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.