Individual provider Active NPI

Eyiyemisi Damisah

  • Neurological Surgery Physician
  • New Haven, CT
National Provider Identifier
1497045264
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
1.059350-RES Issued in CT
Practice address
800 Howard Ave Lowr Level
New Haven, CT 06519-1369
Phone
(203) 785-2805
NPI assigned
Apr 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 1.059350-RES CT Primary

Addresses

Primary practice location

800 Howard Ave Lowr Level
New Haven, CT 06519-1369

Mailing address

360 State St Apt 2112
New Haven, CT 06510-3620
Phone (562) 322-0248

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724001711 CT Practitioner - Neurosurgery 7214256221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Yale University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1.059350-RESCTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Neurological Surgery CurrentSince Jul 1, 2019 Accepting new patients
Yale University CurrentSince Jul 1, 2019 Accepting new patients

Locations

800 Howard Ave
Lowr
New Haven, CT 06519
Phone (203) 737-2096

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

Interoperability endpoints

  • Direct secure messaging: edamisah26944@direct.ynhh.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1497045264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATE ST APT 2112",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103620",
            "telephone_number": "562-322-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE LOWR LEVEL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMISAH",
        "first_name": "EYIYEMISI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "1.059350-RES",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.