NPIMap

Individual provider Active NPI

Bhupesh Mangla, MD

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1649272949
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040017 Issued in CT
Practice address
1450 Chapel St
Department of Medicine, Hospital of Saint Raphael
New Haven, CT 06511-4405
Phone
(203) 789-3203
Fax
(203) 789-3222
NPI assigned
Jun 1, 2005
Last updated
Sep 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 040017 CT
Internal Medicine Physician 207R00000X 040017 CT Primary

Addresses

Primary practice location

1450 Chapel St
Department of Medicine, Hospital of Saint Raphael
New Haven, CT 06511-4405

Mailing address

226 Mill Hill Ave.
3Rd FL.
Bridgeport, CT 06610
Phone (203) 272-2248

Other identifiers 1

IdentifierTypeStateIssuer
001400176MedicaidCT

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
I20040429001308 CT Practitioner - Internal Medicine 9032106067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
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)

226 Mill Hill Ave
Suite 3
Bridgeport, CT 06610-2826
Phone (203) 384-3976

Hospital & facility affiliations

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
040017CTMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Masonicare Behavioral Health, LLC CurrentSince Oct 24, 2016 Accepting new patients
Saint Raphael Faculty Physicians Internal Medicine Past Accepting new patients

Locations

67 Masonic Ave
Fl 1
Wallingford, CT 06492
Phone (203) 265-0355

Interoperability endpoints

  • Direct secure messaging: bmangla100429@direct.ynhh.org

Organizations & group practices 3

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 9

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1649272949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MILL HILL AVE.",
            "address_2": "3RD FL.",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-272-2248",
            "fax_number": "203-272-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "address_2": "DEPARTMENT OF MEDICINE, HOSPITAL OF SAINT RAPHAEL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3203",
            "fax_number": "203-789-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGLA",
        "first_name": "BHUPESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CT",
            "license": "040017",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001400176",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.