NPIMap

Individual provider Active NPI

Farshid Etaee, MD

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1437645108
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
68341 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Jul 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 68341 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231101003800 CA Practitioner - Internal Medicine 6709202385 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iaso Medical Professional GroupGroup PAC ID 2365960275, 4 clinicians
Ellison Medical Group Vein Treatment CenterGroup PAC ID 3274898275, 10 clinicians

Practice addresses (Care Compare)

401 N Brand Blvd
Glendale, CA 91203-4427
Phone (818) 301-9754

4482 Barranca Pkwy
Suite 252
Irvine, CA 92604-1708
Phone (669) 201-0667

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal482

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Iaso Medical Professional Group CurrentSince Aug 26, 2025 Accepting new patients
Ellison Medical Group Vein Treatment Center Specialist CurrentSince Aug 3, 2024 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 1, 2024 Accepting new patients
Washington Heights Medical of New York LLC PastSince Oct 25, 2023 Accepting new patients
Foxhurst Medical of New York LLC Past Accepting new patients
Regen Hospice, Inc. PastSince Aug 26, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine Past Accepting new patients

Locations

401 N Brand Blvd
Ste 726
Glendale, CA 91203
Phone (818) 239-9293

7677 Center Ave
Ste 310
Huntington Beach, CA 92647
Phone (669) 295-0501

4482 Barranca Pkwy
Ste 252
Irvine, CA 92604
Phone (669) 201-0667

File 50670
Los Angeles, CA 90074

1525 Superior Ave
Ste 202
Newport Beach, CA 92663
Phone (669) 295-0501

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

5330 Carroll Canyon Rd
Ste 140
San Diego, CA 92121
Phone (858) 481-4888

244 Madison Ave
#1120
New York, NY 10016
Phone (301) 523-8458

Organizations & group practices 8

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 5

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1437645108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETAEE",
        "first_name": "FARSHID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "68341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.