Individual provider Active NPI

Elizabeth L Cooney, MD

  • Infectious Disease Physician
  • New Haven, CT
National Provider Identifier
1588647705
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
031840 Issued in CT
Practice address
789 Howard Ave
Dana Building - 3Rd Floor
New Haven, CT 06519-1304
Phone
(203) 785-4629
Fax
(203) 785-3588
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 031840 CT Primary

Addresses

Primary practice location

789 Howard Ave
Dana Building - 3Rd Floor
New Haven, CT 06519-1304

Mailing address

PO Box 9805
300 George Street 6TH Floor
New Haven, CT 06536-0805

Other identifiers 1

IdentifierTypeStateIssuer
001318402MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000302 CT Practitioner - Infectious Disease 8325181571 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031840CTMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Infectious Disease CurrentSince Dec 19, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Yale University Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Organizations & group practices 3

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1588647705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9805",
            "address_2": "300 GEORGE STREET 6TH FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065360805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 HOWARD AVE",
            "address_2": "DANA BUILDING - 3RD FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191304",
            "telephone_number": "203-785-4629",
            "fax_number": "203-785-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEY",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "031840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001318402",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.