Individual provider Active NPI

Fern Ellen Mayer, M.D.

  • Dermatology Physician
  • Stamford, CT
National Provider Identifier
1386630085
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
030709 Issued in CT
Practice address
260 Long Ridge Rd Ste 180
Stamford, CT 06902-1638
Phone
(203) 969-0123
Fax
(203) 975-0760
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 030709 CT Primary

Addresses

Primary practice location

260 Long Ridge Rd Ste 180
Stamford, CT 06902-1638

Mailing address

260 Long Ridge Rd Ste D180
Stamford, CT 06902-1638
Phone (203) 969-0123

Other identifiers 1

IdentifierTypeStateIssuer
061398151OtherTAX ID#

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
I20101021000079 CT Practitioner - Dermatology 9830382985 Reassigns benefits to 1 organization
Practice locations: Stamford, CT

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Skinhealth LLPGroup PAC ID 9638309362, 40 clinicians

Practice addresses (Care Compare)

132 Morgan St
Stamford, CT 06905-5431
Phone (646) 630-8588

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions603
Skin biopsy150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030709CTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Skinhealth LLP CurrentSince Oct 1, 2021 Accepting new patients

Locations

4 Corporate Dr
Ste 386
Shelton, CT 06484
Phone (203) 538-5682

132 Morgan St
Stamford, CT 06905
Phone (203) 969-0123

260 Long Ridge Rd
Ste D180
Stamford, CT 06902

Interoperability endpoints

  • Direct secure messaging: fmayer@ctsh.emadirect.md

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1386630085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 LONG RIDGE RD STE D180",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021638",
            "telephone_number": "203-969-0123",
            "fax_number": "203-975-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 LONG RIDGE RD STE 180",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021638",
            "telephone_number": "203-969-0123",
            "fax_number": "203-975-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "FERN",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "030709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "061398151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.