NPIMap

Individual provider Active NPI

David Alan Brill, M.D.

  • Cardiovascular Disease Physician
  • Waterford, CT
National Provider Identifier
1437146404
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301080713 Issued in MI
Practice address
196 Parkway South
Suite 103
Waterford, CT 06385
Phone
(860) 443-4383
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301080713 MI Primary

Addresses

Primary practice location

196 Parkway South
Suite 103
Waterford, CT 06385

Mailing address

226 Mill Hill Ave Ste 333
Bridgeport, CT 06610-2826
Phone (203) 384-4635

Other practice location 1

1031 Suncrest Dr
Lapeer, MI 48446-1136
Phone (810) 664-4870

Other identifiers 2

IdentifierTypeStateIssuer
4906084MedicaidMI
4909980MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160815002533 CT Practitioner - Cardiovascular Disease (Cardiology) 1052308905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Columbia University College of Physicians and Surgeons, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

196 Pkwy S
Suite 103
Waterford, CT 06385
Phone (860) 443-4383

Hospital & facility affiliations

  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020
  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

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
4301080713MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Cardiovascular Disease CurrentSince Apr 1, 2017 Accepting new patients

Locations

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

226 Mill Hill Ave
Ste 333
Bridgeport, CT 06610

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

196 Parkway S
Unit 103
Waterford, CT 06385

196 Parkway S
Ste 103
Waterford, CT 06385
Phone (860) 443-4383

Interoperability endpoints

  • Direct secure messaging: dbrill340634@direct.ynhh.org

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.

Hospital & facility affiliations 9

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1437146404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MILL HILL AVE STE 333",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102826",
            "telephone_number": "203-384-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY SOUTH",
            "address_2": "SUITE 103",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "06385",
            "telephone_number": "860-443-4383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 Suncrest Dr",
            "address_purpose": "LOCATION",
            "city": "Lapeer",
            "state": "MI",
            "postal_code": "484461136",
            "country_code": "US",
            "telephone_number": "810-664-4870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRILL",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301080713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4906084",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4909980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

Verify at the official NPI Registry.