Individual provider Active NPI

Adam Lee Ackerman, MD

  • Hospitalist Physician
  • New Haven, CT
National Provider Identifier
1497982235
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
53701 Issued in CT
Practice address
20 York Street, CB-2041
New Haven, CT 06510-3220
Phone
(203) 688-4748
Fax
(203) 688-4740
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 53701 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

20 York Street, CB-2041
New Haven, CT 06510-3220

Mailing address

20 York Street, CB-2041
New Haven, CT 06510-3220
Phone (203) 688-4748

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826001978 CT Practitioner - HospitalistPractitioner - Internal Medicine 7911157193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Tufts University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group Inc 1,357 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4741

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Aug 3, 2015 Accepting new patients
Mat-Su Valley Medical Center LLC Hospitalist Past Accepting new patients

Locations

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: aackerman317983@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.

Hospital & facility affiliations 2

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1497982235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "ADAM",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "53701",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.