Individual provider Active NPI

Elisa Marie Girard, MD

  • Obstetrics & Gynecology Physician
  • Groton, CT
National Provider Identifier
1700861689
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
047489 Issued in CT
Practice address
491 Gold Star Hwy
Ste 100
Groton, CT 06340-6206
Phone
(860) 445-5107
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 047489 CT Primary

Addresses

Primary practice location

491 Gold Star Hwy
Ste 100
Groton, CT 06340-6206

Mailing address

491 Gold Star Hwy
Ste 100
Groton, CT 06340-6206
Phone (860) 445-5107

Other names 1

  • Elisa Marie Peralta Former name

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
I20090831000660 CT Practitioner - Obstetrics/Gynecology 8325193154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Un of California, Irvine, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women's Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

491 Gold Star Hwy
Suite 100
Groton, CT 06340-6226
Phone (860) 445-5107

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047489CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Obstetrics & Gynecology CurrentSince Sep 1, 2009 Accepting new patients

Locations

22 Waterville Rd
Avon, CT 06001
Phone (860) 678-3461

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

491 Gold Star Hwy
Ste 100
Groton, CT 06340
Phone (860) 445-4290

Interoperability endpoints

  • Direct secure messaging: elisa.girard.1@10170.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1700861689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 GOLD STAR HWY",
            "address_2": "STE 100",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406206",
            "telephone_number": "860-445-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 GOLD STAR HWY",
            "address_2": "STE 100",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406206",
            "telephone_number": "860-445-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARD",
        "first_name": "ELISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "047489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "PERALTA",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.