Individual provider Active NPI

Yitzchok Lederman, MD

  • Internal Medicine Physician
  • Farmington, CT
National Provider Identifier
1619473253
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
069050 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-1921
Phone
(860) 679-2147
Fax
(860) 679-4624
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 69050 CT
Internal Medicine Physician 207R00000X 069050 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-1921

Mailing address

263 Farmington Ave
Farmington, CT 06030-1921
Phone (860) 679-2147

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ylederman13573@direct.med.uchc.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210730001833 CT Practitioner - Hospitalist 4082962980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069050CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Jan 1, 2023 Accepting new patients
University of Connecticut Health Center Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 30, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 30, 2021 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

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

Interoperability endpoints

  • Direct secure messaging: ylederman13573@direct.med.uchc.edu

Organizations & group practices 5

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 3

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1619473253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921",
            "telephone_number": "860-679-2147",
            "fax_number": "860-679-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921",
            "telephone_number": "860-679-2147",
            "fax_number": "860-679-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "YITZCHOK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "69050",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "069050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ylederman13573@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060301921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.