Pavan Kumar Challa, MD
Individual provider Active NPI Hospitalist Physician · New Haven, CT
NPI 1417416660 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1417416660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- 70680 (CT)
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 688-4242
- NPI assigned
- Mar 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Medical Group Inc
Practice addresses (Care Compare)
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4741
Hospital & facility affiliations
- Yale-New Haven Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220802002584 | CT | Practitioner - Hospitalist | 6901131085 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70680 | CT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Medical Group, Inc. | Single Specialty | Current |
Accepting new patients |
| Mill Hill Medical Consultants Inc | Single Specialty | Current |
Accepting new patients |
Locations
20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741
1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151
20 York St
North Haven, CT 06510
Phone (203) 688-2433
20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
Interoperability endpoints
- pchalla365955@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program |
390200000X | |||
| Hospitalist Physician | 208M00000X | 70680 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
100 Jefferson SQ Apt 5D
Waterbury, CT 06706-1135
Phone (972) 215-9300
Other practice location 1
56 Franklin St
Waterbury, CT 06706-1253
Phone (972) 215-9300
Other providers in New Haven, CT
- Catherine Aileen Chagnon
- Anees B Chagpar
- Hector Enrique Chaidez Ruacho
- Akash Chakravartty
- Mary Chalino
- Muralikrishna Challagundla
- Alison Brooke Chamberlain
- Danielle Chamberlin
- Angelina Naomi Chambers
- Shanai Chambers
All providers in New Haven, CT · Hospitalist Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.