Elijah Adams
Individual provider Active NPI Physician Assistant · Waterbury, CT
NPI 1598570939 · NPPES record last updated Apr 14, 2025
Key facts
- NPI
- 1598570939
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 64 Robbins St
Waterbury, CT 06708-2613 - Phone
- (269) 329-9989
- NPI assigned
- Feb 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250519000454 | CT | Practitioner - Physician Assistant | 7618495243 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
64 Robbins St
Waterbury, CT 06708-2613
Mailing address
55 Manorwood Dr
Branford, CT 06405-3001
Phone (269) 329-9989
Other providers in Waterbury, CT
- Achieve Rehab LLC
- Danielle Marie Ackley
- Acu Medical Supplies LLC
- Debra Adamo
- Cara Adams
- Sarah Ann Adams
- Ireneo Malabanan Adao
- Maham Leeza Adil
- Adir Wellness LLC
- Juliana Osei Adjepong
All providers in Waterbury, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.