NPIMap

Individual provider Active NPI

Channa Perera, M.D.

  • Internal Medicine Physician
  • West Haven, CT
National Provider Identifier
1467458216
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036182 Issued in CT
Practice address
755 Campbell Ave Ste 3
West Haven, CT 06516-3715
Phone
(203) 937-1100
Fax
(203) 937-1102
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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 036182 CT Primary

Addresses

Primary practice location

755 Campbell Ave Ste 3
West Haven, CT 06516-3715

Mailing address

755 Campbell Ave Ste 3
West Haven, CT 06516-3715
Phone (203) 937-1100

Other identifiers 7

IdentifierTypeStateIssuer
00136823MedicaidCT
110194409OtherCTRAILROAD MEDICARE
708711OtherCTCONNECTICARE
010036182CT01OtherCTANTHEM BLUE SHIELD
P1013460OtherCTOXFORD
2026973OtherCTAETNA
0V7493OtherCTHEALTHNET

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
I20090202000105 CT Practitioner - Internal Medicine 8123182417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Campbell Medical Services LLCGroup PAC ID 2163586454, 12 clinicians

Practice addresses (Care Compare)

755 Campbell Ave
Suite 1
West Haven, CT 06516-3789
Phone (203) 937-1100

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Home health agency, Milford, CT, CCN 077143
  • Orange Visiting Nurse Association Home health agency, Orange, CT, CCN 077078
  • Constellation Home Care Hospice, Norwalk, CT, CCN 071542
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Bradley Home Infirmary/Pavilion Nursing home, Meriden, CT, CCN 075439
  • Grandview Rehabilitation and Healthcare Center Nursing home, New Britain, CT, CCN 075182
  • Guilford House, the Nursing home, Guilford, CT, CCN 075235
  • Montowese Center for Health & Rehabilitation Nursing home, North Haven, CT, CCN 075017
  • Arden Care Center Nursing home, Hamden, CT, CCN 075228

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC CurrentSince Jan 24, 2024 Accepting new patients
Campbell Med LTC LLC Internal Medicine Current Accepting new patients
Campbell Medical Services, LLC Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
225 Amity Rd Opco LLC PastSince Nov 28, 2023 Accepting new patients

Locations

850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500

80 Fern Dr
Torrington, CT 06790
Phone (203) 294-7300

755 Campbell Ave
Ste 1
West Haven, CT 06516
Phone (203) 937-1100

755 Campbell Ave
Ste 3
West Haven, CT 06516
Phone (203) 937-1100

250 Skillman St
Ste 202
Brooklyn, NY 11205

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Autumn Lake Healthcare at the WillowsWoodbridge, CT, CCN 075331 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 28, 2023
Nov 28, 2023
Arden Care CenterHamden, CT, CCN 075228 Skilled nursing facility Contracted Managing Employee Jun 3, 2024
Grandview Rehabilitation and Healthcare CenterNew Britain, CT, CCN 075182 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 10, 2025
Aug 6, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 12

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1467458216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 CAMPBELL AVE STE 3",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163715",
            "telephone_number": "203-937-1100",
            "fax_number": "203-937-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 CAMPBELL AVE STE 3",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163715",
            "telephone_number": "203-937-1100",
            "fax_number": "203-937-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "CHANNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00136823",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110194409",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "708711",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "010036182CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1013460",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2026973",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V7493",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.