Individual provider Active NPI

Stephan Ariyan, M.D.

  • Plastic and Reconstructive Surgery Physician
  • New Haven, CT
National Provider Identifier
1578583282
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
013681 Issued in CT
Practice address
60 Temple St Ste 7C
New Haven, CT 06510-2716
Phone
(203) 786-3000
Fax
(203) 772-2814
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 013681 CT Primary

Addresses

Primary practice location

60 Temple St Ste 7C
New Haven, CT 06510-2716

Mailing address

60 Temple St Ste 4B
New Haven, CT 06510-2716
Phone (203) 786-3000

Other identifiers 1

IdentifierTypeStateIssuer
001136811MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013681CTMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elevation Plastic Surgery, PC Past Accepting new patients
Yale University Past Accepting new patients

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1578583282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 TEMPLE ST STE 4B",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102716",
            "telephone_number": "203-786-3000",
            "fax_number": "203-772-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TEMPLE ST STE 7C",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102716",
            "telephone_number": "203-786-3000",
            "fax_number": "203-772-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIYAN",
        "first_name": "STEPHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "013681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001136811",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.