Carlos Alberto Enciso Chaves, M.D.
Individual provider Active NPI Psychiatry Physician · Stafford Springs, CT
NPI 1669635645 · NPPES record last updated Sep 24, 2018
Key facts
- NPI
- 1669635645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 49483 (CT)
- Practice address
- 201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005 - Phone
- (860) 714-2750
- Fax
- (860) 714-8591
- NPI assigned
- Jul 9, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yale University
Practice addresses (Care Compare)
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Hospital & facility affiliations
- Yale-New Haven Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110908001689 | CT | Practitioner - Psychiatry | 1759551450 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49483 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Health of New England Provider Network Organization Inc | Current |
Accepting new patients | |
| The Charlotte Hungerford Hospital | Current |
Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current |
Accepting new patients | |
| The Griffin Hospital | Psychiatry | Current |
Accepting new patients |
| Yale University | Current |
Accepting new patients | |
| Neighborhood Health, Inc. | Psychiatry | Current |
Accepting new patients |
| Natchaug Hospital, Inc. | Current |
Accepting new patients | |
| Yale University | Psychiatry | Current |
Accepting new patients |
| The Charlotte Hungerford Hospital | Current |
Accepting new patients |
Locations
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000
130 Division St
Derby, CT 06418
Phone (203) 732-1330
500 Blue Hills Ave
Hartford, CT 06112
Phone (860) 714-2681
675 Tower Ave
Ste 301
Hartford, CT 06112
Phone (860) 714-2338
114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001
189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
50 Division St
New Haven, CT 06511
Phone (203) 785-2140
20 York St
North Haven, CT 06510
Phone (203) 688-2433
201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521
540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361
47 Long Lots Rd
Westport, CT 06880
Phone (203) 221-8801
Interoperability endpoints
- carlos.encisco-chaves@xdr.hhchealthdirect.org
- cencisochaves599089@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 49483 | CT | Yes |
Addresses
Primary practice location
201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005
Mailing address
675 Tower Ave
Suite 301
Hartford, CT 06112-1273
Phone (860) 714-2750
Other practice location 1
675 Tower Ave
Suite 301
Hartford, CT 06112-1273
Phone (860) 714-2750
Other practice location 2
114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-2750
Other practice location 3
500 Blue Hills Ave
Hartford, CT 06112-1500
Phone (860) 714-2750
Other providers in Stafford Springs, CT
- Echn Johnson Evergreen Corporation
- Echn Johnson Memorial Hospital, Inc.
- Echn Johnson Memorial Hospital, Inc.
- Deborah Eddinger
- Laura Namata Ekatan
- Brendan Evans
- Evergreen Acquisition Operator, LLC
- Lisa Fargnoli
- Cynthia L Ferree
- Karen Louise Friedmann
All providers in Stafford Springs, CT · Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.