Eileen Mary Tichy, PAC RD

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001042 Issued in CT

Practice address

2 Church St S
Suite 401
New Haven, CT 06519-1717

Phone

(203) 785-5192

NPI assigned

Oct 31, 2006

Last updated

Apr 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: etichy4793@direct.ynhh.org

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.

• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Fairfield County Medical Services Inc

  dba Norwalk Hospital Physicians and Surgeons

  • Specialist
  • Norwalk, CT
  • NPI 1134178577
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1699851568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 TALCOTT RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064375001",
            "telephone_number": "203-204-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "SUITE 401",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-785-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICHY",
        "first_name": "EILEEN",
        "middle_name": "MARY",
        "credential": "PAC RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001042",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "PENDING",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Thurlow, MSW
• Shreeya Thussu
• Tamires Tiburtino
• Siena Tice
• Douglas Edwin Tichy, PA-C
• Mayanka Tickoo, M.D., M.S.
• Sunil Kumar Tickoo, RPH
• Roger Tieu
• Lauren Tiffen, DDS, CPH
• Robert E Tigelaar, MD

• Medical Physician Assistant in New Haven, CT
• Providers in New Haven, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.