NPIMap

Organization Active NPI

New Era Rehabilitation Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Haven, CT
National Provider Identifier
1780919951
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0381 Issued in CT
Legal business name
NEW ERA REHABILITATION CENTER, INC.
Practice address
311 East Street
New Haven, CT 06511-5838
Phone
(203) 562-2101
Fax
(203) 562-2102
NPI assigned
Oct 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Mr. Ebenezer A Kolade, MD
Title
Executive Director
Phone
(203) 562-2101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0381 CT Primary
Methadone Clinic 261QM2800X 0381 CT

Addresses

Primary practice location

311 East Street
New Haven, CT 06511-5838

Mailing address

311 East Street
New Haven, CT 06511-5838
Phone (203) 562-2101

Other identifiers 2

IdentifierTypeStateIssuer
261QM0201XOtherTAXONOMY
008004032MedicaidCT

Other names 1

  • New Era Rehabilitation Center, Inc. NH Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments
Opioid treatment program
Medicare-enrolled since Jul 6, 2021

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051006000655 CT Part B Supplier - Clinic/Group Practice 3072538263 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bridgeport, CT; New Haven, CT
O20211103000532 CT Part B Supplier - Opioid Treatment Program (Otp) 3072538263 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Haven, CT; Bridgeport, CT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
New Era Rehabilitation Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3851 Main St
Bridgeport, CT 06606
Phone (203) 372-3333

4675 Main St
Rear Entrance
Bridgeport, CT 06606
Phone (203) 344-0025

311 East St
New Haven, CT 06511
Phone (203) 344-0025

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1780919951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 EAST STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115838",
            "telephone_number": "203-562-2101",
            "fax_number": "203-562-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 EAST STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115838",
            "telephone_number": "203-562-2101",
            "fax_number": "203-562-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ERA REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "KOLADE",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "203-562-2101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "0381",
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CT",
            "license": "0381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261QM0201X",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008004032",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Era Rehabilitation Center, Inc. NH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.