Elizabeth Marie Cerezo

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5340 Issued in CT

Practice address

1650 Dixwell Ave
Hamden, CT 06514-3615

Phone

(203) 288-1700

NPI assigned

Apr 21, 2021

Sex

Female

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fair Haven Community Health Clinic IncGroup PAC ID 4183511538, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fair Haven Community Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1104803444
  Medicare reassignment Care Compare group NPD
• Fair Haven Community Health Clinic, Inc

  dba Grand Pharmacy

  • Community/Retail Pharmacy
  • Branford, CT
  • NPI 1760051486
  NPD

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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1447832266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143615",
            "telephone_number": "203-288-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143615",
            "telephone_number": "203-288-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEREZO",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn V Cathey, LCSW
• Ashley Cegelka
• Jessica Cegelka, PHARMD
• Elana Celliers, DMD
• Center for Orthopaedics, PC
• Bruce Y Cha, DMD
• Gillian Ross Chadderton
• Anmol Vipin Chadha, DPT
• Mark Chamberlain, PA
• Francis Wing-Kai Chan, MD

• Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.