NPIMap

Individual provider Active NPI

Elizabeth McKinnis, M.D.

  • Internal Medicine Physician
  • Fairfield, CT
National Provider Identifier
1659628915
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
043102 Issued in CT
Practice address
363 Reef Rd
Suite201
Fairfield, CT 06824-6582
Phone
(203) 255-0891
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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 043102 CT Primary

Addresses

Primary practice location

363 Reef Rd
Suite201
Fairfield, CT 06824-6582

Mailing address

363 Reef Rd
Suite201
Fairfield, CT 06824-6582
Phone (203) 255-0891

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
I20130220000139 CT Practitioner - Internal Medicine 6608021878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

333 Post Rd W
Westport, CT 06880-4754
Phone (203) 226-0731

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043102CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Oct 1, 2014 Accepting new patients
Fairfield County Medical Services Inc Internal Medicine Past Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

363 Reef Rd
Ste 201
Fairfield, CT 06824
Phone (203) 255-0891

38 East Ave
New Canaan, CT 06840
Phone (203) 594-9520

131 Kings Hwy N
Westport, CT 06880
Phone (203) 221-0102

333 Post Rd W
Westport, CT 06880
Phone (203) 226-0731

Interoperability endpoints

  • Direct secure messaging: bmckinnis@imaw.gwaydirect.com

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1659628915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 REEF RD",
            "address_2": "SUITE201",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246582",
            "telephone_number": "203-255-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 REEF RD",
            "address_2": "SUITE201",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246582",
            "telephone_number": "203-255-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNIS",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "043102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.