Individual provider Active NPI

Carlo Bruno Bifulco, MD

  • Anatomic Pathology Physician
  • New Haven, CT
National Provider Identifier
1528057155
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
041504 Issued in CT
Practice address
20 York St
Yale-New Haven Children'S Hospital-Ep 2608
New Haven, CT 06510-3220
Phone
(203) 785-3624
Fax
(203) 785-7037
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 041504 CT Primary

Addresses

Primary practice location

20 York St
Yale-New Haven Children'S Hospital-Ep 2608
New Haven, CT 06510-3220

Mailing address

PO Box 9805
300 George St 6TH Floor
New Haven, CT 06536-0805
Phone (203) 785-7998

Other identifiers 1

IdentifierTypeStateIssuer
001415402MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20090120000431 OR Practitioner - Pathology 5092612366 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.53 of 100Reported as group
Quality
96.2
Promoting interoperability
100
Improvement activities
40
Cost
84.49

Merit-based Incentive Payment System (MIPS)

Final score
95.65 of 100Reported as group
Quality
98.12
Promoting interoperability
100
Improvement activities
40
Cost
80.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 2, 2008 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 2, 2008 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 16, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 16, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 16, 2015 Accepting new patients
Yale University Past Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4400 NE Halsey St
Bldg 3
Portland, OR 97213
Phone (503) 215-6660

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 3

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1528057155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9805",
            "address_2": "300 GEORGE ST 6TH FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065360805",
            "telephone_number": "203-785-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YALE-NEW HAVEN CHILDREN'S HOSPITAL-EP 2608",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-3624",
            "fax_number": "203-785-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIFULCO",
        "first_name": "CARLO",
        "middle_name": "BRUNO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CT",
            "license": "041504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001415402",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.