Eliza Fantarella, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

000867 Issued in CT

Practice address

330 Orchard St
New Haven, CT 06511

Phone

(203) 789-3152

Fax

(203) 867-5457

NPI assigned

Jun 17, 2008

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

Other identifiers 1

Other names 1

• Eliza Addis-Thomas Former name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Foot Surgeons PCGroup PAC ID 5395647135, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efantarella2352@direct.ynhh.org

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.

• Affiliated Foot Surgeons PC

  • Foot & Ankle Surgery Podiatrist
  • New Haven, CT
  • NPI 1760690572
  Medicare reassignment Care Compare group NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351

  Foot & Ankle Surgery

  Medicare reassignment NPD
• Mill Hill Medical Consultants Inc

  • Pain Medicine (Anesthesiology) Physician
  • Greenwich, CT
  • NPI 1144230954
  NPD
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  dba Affiliated Physicians of Saint Raphael

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1437319019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-789-3152",
            "fax_number": "203-867-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-789-3152",
            "fax_number": "203-867-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTARELLA",
        "first_name": "ELIZA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437319019",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "ADDIS-THOMAS",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Family Centered Services of CT
• Eric Fan, M.D.
• Kathleen Fan, MD
• Courtney Fankhanel
• Erin Fannon
• Melissa Fappiano
• Mariam Elizabeth Farah, PHARMD, RPH
• Kristen Leigh Fardelmann, MD
• Andrea Cristina Farela Rodriguez, M.D.
• Barbara Farell, LPC

• Foot & Ankle Surgery Podiatrist in New Haven, CT
• Providers in New Haven, CT by specialty
• Foot & Ankle Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.