Alexander A Carrese, M.D
Individual provider Active NPI Obstetrics Physician · Derby, CT
NPI 1720170616 · NPPES record last updated Apr 23, 2013
Key facts
- NPI
- 1720170616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics Physician 207VX0000X
- License
- 027885 (CT)
- Practice address
- 299 Seymour Ave
Derby, CT 06418-1342 - Phone
- (203) 735-3347
- Fax
- (203) 734-5732
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
299 Seymour Ave
Derby, CT 06418-1342
Phone (203) 735-3347
Hospital & facility affiliations
- Griffin 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 |
|---|---|---|---|---|
| I20080819000323 | CT | Practitioner - Obstetrics/Gynecology | 0941375471 | Practice locations: Derby, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027885 | CT | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield County Medical Services Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 027885 | CT | Yes |
Addresses
Primary practice location
299 Seymour Ave
Derby, CT 06418-1342
Mailing address
33 Nature LN
Shelton, CT 06484-4220
Phone (203) 929-7737
Other providers in Derby, CT
- Scott B Callahan
- Amber L Cammarata
- Amber Canavan
- Alexis Cardinali
- Cardiology Associates of Derby PC
- Jonna J Carroll
- Jillian Rae Celentano
- Lauren Nicole Ceriello
- Kathleen M Chaisson
- Ranjit S Chandpuri
All providers in Derby, CT · Obstetrics 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 Apr 23, 2013. 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.