Individual provider Active NPI

Stephanie R. Vaz, MD

  • Obstetrics & Gynecology Physician
  • New Haven, CT
National Provider Identifier
1578676292
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
041957 Issued in CT
Practice address
1450 Chapel Street
Saint Raphael Faculty Physicians
New Haven, CT 06511
Phone
(203) 789-4074
Fax
(203) 867-5534
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 041957 CT Primary

Addresses

Primary practice location

1450 Chapel Street
Saint Raphael Faculty Physicians
New Haven, CT 06511

Mailing address

PO Box 18263
Saint Raphael Faculty Physicians
Bridgeport, CT 06601-3263
Phone (508) 595-0531

Other identifiers 1

IdentifierTypeStateIssuer
001419573MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150619002186 FL Practitioner - Obstetrics/Gynecology 3779485222 Reassigns benefits to 1 organization
I20240717001647 GA Practitioner - Obstetrics/Gynecology 3779485222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Hahnemann University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Georgia, P.C.Group PAC ID 9032383583, 34 clinicians

Practice addresses (Care Compare)

1700 Medical Way
Snellville, GA 30078-2195
Phone (800) 967-2289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041957CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Georgia, P.C. Obstetrics & Gynecology CurrentSince Apr 16, 2025 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jan 1, 2014 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jan 1, 2014 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Saint Raphael Faculty Physicians Obstetrics & Gynecology Past Accepting new patients
Eastside Medical Center, LLC Past Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Obstetrics & Gynecology Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

Organizations & group practices 7

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1578676292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18263",
            "address_2": "SAINT RAPHAEL FACULTY PHYSICIANS",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066013263",
            "telephone_number": "508-595-0531",
            "fax_number": "508-829-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL STREET",
            "address_2": "SAINT RAPHAEL FACULTY PHYSICIANS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-789-4074",
            "fax_number": "203-867-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZ",
        "first_name": "STEPHANIE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "041957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001419573",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.