NPIMap

Individual provider Active NPI

Ann R Datunashvili, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • New Haven, CT
National Provider Identifier
1376544932
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
039938 Issued in CT
Practice address
874 Howard Ave
New Haven, CT 06519-1106
Phone
(203) 688-8200
Fax
(203) 688-8204
NPI assigned
Aug 4, 2005
Last updated
Mar 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 039938 CT Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000919 CT Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2264423078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039938CTMDGeriatric Medicine (Internal Medicine) Physician

Interoperability endpoints

  • Direct secure messaging: adatunashvili5814@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1376544932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191106",
            "telephone_number": "203-688-8200",
            "fax_number": "203-688-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191106",
            "telephone_number": "203-688-8200",
            "fax_number": "203-688-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATUNASHVILI",
        "first_name": "ANN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "039938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.