Individual provider Active NPI

Ali Vaezy, MD

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1396722575
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
040741 Issued in CT
Practice address
20 York St
Ynhh West Pavilion, 2ND FL
New Haven, CT 06510-3220
Phone
(203) 785-4081
Fax
(203) 737-2228
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 040741 CT Primary

Addresses

Primary practice location

20 York St
Ynhh West Pavilion, 2ND FL
New Haven, CT 06510-3220

Mailing address

20 York St
Ynhh West Pavilion, 2ND FL
New Haven, CT 06510-3220
Phone (203) 785-4081

Other identifiers 11

IdentifierTypeStateIssuer
001407411MedicaidCT
220133OtherCTWELLCARE
3408207/7603504OtherCTAETNA
23-33843OtherCTUHC
PENDINGOtherCTRR MEDICARE
23-33843OtherCTAMERICHOICE
912708OtherCTUSA
010040741CT02OtherCTANTHEM BCBS CT
040741OtherCTCONNECTICARE
2V1459OtherCTHEALTHNET/COMMERCIAL
P2978576OtherCTOXFORD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avaezy222873@direct.stfranciscare.org Direct

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
I20040113000062 CT Practitioner - Pediatric MedicinePractitioner - Internal Medicine 3577463710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kentucky College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040741CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Nov 19, 2003 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Yale University CurrentSince Nov 19, 2003 Accepting new patients
Yale University Pediatrics Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

20 York St
North Haven, CT 06510
Phone (203) 688-2433

133 Scovill St
Ste 306
Waterbury, CT 06706
Phone (203) 709-3667

Interoperability endpoints

  • Direct secure messaging: avaezy2389327@direct.trinity-health.org

Organizations & group practices 5

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.

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1396722575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YNHH WEST PAVILION, 2ND FL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-4081",
            "fax_number": "203-737-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YNHH WEST PAVILION, 2ND FL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-4081",
            "fax_number": "203-737-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAEZY",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "040741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001407411",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "220133",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3408207/7603504",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "23-33843",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "23-33843",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA",
            "identifier": "912708",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS CT",
            "identifier": "010040741CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "040741",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET/COMMERCIAL",
            "identifier": "2V1459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2978576",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avaezy222873@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "133 Scovill St Ste 306",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067061127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.