Individual provider Active NPI

Beverley Jeanne Sheares, MD, MS

  • Pediatric Pulmonology Physician
  • New Haven, CT
National Provider Identifier
1629041744
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
60460 Issued in CT
Practice address
333 Cedar St
New Haven, CT 06510
Phone
(032) 785-2480
Fax
(203) 785-6337
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 182028 NY
Pediatric Pulmonology Physician 2080P0214X 60460 CT Primary

Addresses

Primary practice location

333 Cedar St
New Haven, CT 06510

Mailing address

333 Cedar Street
PO Box 208064, Lmp3096A
New Haven, CT 06520
Phone (032) 785-2480

Other identifiers 1

IdentifierTypeStateIssuer
01187719MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806000295 CT Practitioner - Pediatric Medicine 0648232074 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182028NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Hospital CurrentSince Sep 2, 2018 Accepting new patients
Yale University CurrentSince Jul 1, 2018 Accepting new patients
Greenwich Hospital CurrentSince Sep 2, 2018 Accepting new patients
Yale University CurrentSince Jul 1, 2018 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

333 Cedar St
New Haven, CT 06510
Phone (203) 432-4771

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Park St
North Haven, CT 06504
Phone (203) 785-4643

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: bsheares401230@direct.ynhh.org

Organizations & group practices 4

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1629041744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR STREET",
            "address_2": "PO BOX 208064, LMP3096A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06520",
            "telephone_number": "032-785-2480",
            "fax_number": "203-785-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "032-785-2480",
            "fax_number": "203-785-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARES",
        "first_name": "BEVERLEY",
        "middle_name": "JEANNE",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "182028",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CT",
            "license": "60460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01187719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.