Individual provider Active NPI

Tamar Ranon Braverman, MD

  • Internal Medicine Physician
  • Hamden, CT
National Provider Identifier
1639185093
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040175 Issued in CT
Practice address
2560 Dixwell Ave
#2-B
Hamden, CT 06514-1851
Phone
(203) 230-2546
Fax
(203) 288-5059
NPI assigned
Jul 31, 2006
Last updated
May 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 040175 CT Primary

Addresses

Primary practice location

2560 Dixwell Ave
#2-B
Hamden, CT 06514-1851

Mailing address

2560 Dixwell Ave
#2-B
Hamden, CT 06514-1851
Phone (203) 230-2546

Other identifiers 1

IdentifierTypeStateIssuer
1639185093MedicaidCT

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
I20100721000212 CT Practitioner - Internal Medicine 4688706088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Yale University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

2560 Dixwell Ave
Suite 2B
Hamden, CT 06514-1852
Phone (203) 230-2546

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040175CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Branford Internal Medicine LLC Internal Medicine PastSince May 15, 2000 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

2560 Dixwell Ave
Ste 2B
Hamden, CT 06514
Phone (203) 230-0700

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: tamar.braverman.npi1639185093.phpct@direct.optumcare.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1639185093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 DIXWELL AVE",
            "address_2": "#2-B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141851",
            "telephone_number": "203-230-2546",
            "fax_number": "203-288-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 DIXWELL AVE",
            "address_2": "#2-B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141851",
            "telephone_number": "203-230-2546",
            "fax_number": "203-288-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "TAMAR",
        "middle_name": "RANON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639185093",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.