Individual provider Active NPI

Elyse R Erlich, MD

  • Internal Medicine Physician
  • Stamford, CT
National Provider Identifier
1376614750
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55333 Issued in CT
Practice address
260 Long Ridge Rd
Stamford, CT 06902-1627
Phone
(475) 619-6035
Fax
(203) 316-0288
NPI assigned
Nov 10, 2006
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191306 NY
Internal Medicine Physician 207R00000X 55333 CT Primary

Addresses

Primary practice location

260 Long Ridge Rd
Stamford, CT 06902-1627

Mailing address

260 Long Ridge Rd
Stamford, CT 06902-1627
Phone (475) 619-6035

Other identifiers 1

IdentifierTypeStateIssuer
55333OtherCTCT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071107000509 NY Practitioner - Internal Medicine 2163519109 Reassigns benefits to 1 organization
I20160823001923 CT Practitioner - Internal Medicine 2163519109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

260 Long Ridge Rd
Stamford, CT 06902-1638
Phone (475) 319-6035

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
55333CTMDInternal Medicine Physician
191306NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Sep 5, 2016 Accepting new patients
Northeast Medical Group, PLLC Internal Medicine CurrentSince Jul 20, 2021 Accepting new patients
Sound Shore Gastroenterology Associates PC Past Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

260 Long Ridge Rd
Stamford, CT 06902
Phone (203) 863-3000

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

18 Rye Ridge Plz
Rye Brook, NY 10573
Phone (914) 253-9252

Interoperability endpoints

  • Direct secure messaging: eerlich344359@direct.ynhh.org

Organizations & group practices 3

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 1

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1376614750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021627",
            "telephone_number": "475-619-6035",
            "fax_number": "203-316-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021627",
            "telephone_number": "475-619-6035",
            "fax_number": "203-316-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERLICH",
        "first_name": "ELYSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191306",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "55333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "55333",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.