Rena Chase Fortier, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

036076 Issued in CT

Practice address

1051 Long Ridge Rd
Stamford, CT 06903-4436

Phone

(203) 329-7960

Fax

(203) 329-7920

NPI assigned

Sep 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Ridge Dermatology LLCGroup PAC ID 4183625957, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Long Ridge Dermatology,LLC

  • Specialist
  • Stamford, CT
  • NPI 1326100553
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396730610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069034436",
            "telephone_number": "203-329-7960",
            "fax_number": "203-329-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069034436",
            "telephone_number": "203-329-7960",
            "fax_number": "203-329-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIER",
        "first_name": "RENA",
        "middle_name": "CHASE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "036076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Caroll Ford, OTR/L
• Erin Forler, LCSW
• Gabriella Forman, M.D.
• Sharon M Fornaciari, MS, LPC
• Fortaleza Therapeutic Services, PLLC
• Tabitha Fortt, MD
• Alec Fouche, PHARM. D
• Foundations Developmental and Behavioral Pediatrics PLLC
• Martin Fox, MD
• Ava Fracassini, OTR/L

• Specialist in Stamford, CT
• Providers in Stamford, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.