Individual provider Active NPI

Robin Leigh Fiftal, PA-C

  • Physician Assistant
  • New Haven, CT
National Provider Identifier
1508393521
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3854 Issued in CT
Practice address
1 Park St
New Haven, CT 06504-8901
Phone
(203) 688-3000
NPI assigned
May 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3854 CT Primary

Addresses

Primary practice location

1 Park St
New Haven, CT 06504-8901

Mailing address

39 Old Colony Rd
Monroe, CT 06468-1279
Phone (203) 331-7058

Other practice location 1

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171227000843 CT Practitioner - Physician Assistant 6901164722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3854CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Hospital CurrentSince Oct 17, 2017 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

305 Boston Ave
Bridgeport, CT 06610
Phone (203) 384-3377

Interoperability endpoints

  • Direct secure messaging: rfiftal331819@direct.ynhh.org

Organizations & group practices 1

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508393521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OLD COLONY RD",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681279",
            "telephone_number": "203-331-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065048901",
            "telephone_number": "203-688-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066102805",
            "country_code": "US",
            "telephone_number": "203-384-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIFTAL",
        "first_name": "ROBIN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.