NPIMap

Individual provider Active NPI

Kimberly Michelle Glerum, MD

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1609405802
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75778 Issued in CT
Practice address
20 York St
Tompkins 226
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Apr 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 75778 CT Primary

Addresses

Primary practice location

20 York St
Tompkins 226
New Haven, CT 06510-3220

Mailing address

20 York St
Tompkins 226
New Haven, CT 06510-3220
Phone (203) 688-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726001259 CT Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0345663753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

1354 Chapel St
New Haven, CT 06511-4420
Phone (203) 867-8300

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Home health agency, Milford, CT, CCN 077143
  • Masters in Home Care, LLC Home health agency, Rocky Hill, CT, CCN 077264
  • Connecticut Hospice Inc, the Hospice, Branford, CT, CCN 071500
  • Home Care Plus, Inc Hospice, Guilford, CT, CCN 071544
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Evergreen Woods Nursing home, North Branford, CT, CCN 075362

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75778CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince Aug 11, 2024 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Aug 11, 2024 Accepting new patients

Locations

874 Howard Ave
New Haven, CT 06519
Phone (203) 688-8200

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

20 York St
North Haven, CT 06510
Phone (203) 688-2433

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: kglerum436845@direct.ynhh.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Evergreen WoodsNorth Branford, CT, CCN 075362 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2025
Apr 4, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699056000000",
    "number": "1609405802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "TOMPKINS 226",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "TOMPKINS 226",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLERUM",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "75778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.