Individual provider Active NPI

Mahnoosh Sharifi, M.D.

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1750549531
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
054971 Issued in CT
Practice address
789 Howard Ave
New Haven, CT 06519-1304
Phone
(203) 688-5555
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 243744 MA
Pediatrics Physician 208000000X 054971 CT Primary

Addresses

Primary practice location

789 Howard Ave
New Haven, CT 06519-1304

Mailing address

330 Cedar St
New Haven, CT 06510-3218

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
I20160628002149 CT Practitioner - Pediatric Medicine 6002000718 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054971CTMDPediatrics Physician
243744MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
Yale University CurrentSince Jul 1, 2016 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

330 Cedar St
New Haven, CT 06510
Phone (203) 785-2385

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: msharifi339054@direct.ynhh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1750549531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191304",
            "telephone_number": "203-688-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFI",
        "first_name": "MAHNOOSH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "243744",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "054971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.