Individual provider Active NPI

Robert F. Berke Schlessel, MD

  • Surgery Physician
  • New Haven, CT
National Provider Identifier
1578595351
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
021634 Issued in CT
Practice address
2 Church St S
Ste 504
New Haven, CT 06519-1717
Phone
(203) 624-0006
Fax
(203) 562-4694
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 021634 CT Primary

Addresses

Primary practice location

2 Church St S
Ste 504
New Haven, CT 06519-1717

Mailing address

2 Church St. South
Ste 504
New Haven, CT 06519-1717
Phone (203) 624-0006

Other identifiers 1

IdentifierTypeStateIssuer
001216340MedicaidCT

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
021634CTMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1578595351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST. SOUTH",
            "address_2": "STE 504",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-624-0006",
            "fax_number": "203-562-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "STE 504",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-624-0006",
            "fax_number": "203-562-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLESSEL",
        "first_name": "ROBERT",
        "middle_name": "F. BERKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "021634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001216340",
            "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 Jun 3, 2014; 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.