Individual provider Active NPI

Ellen Gingerella, PA-C

  • Physician Assistant
  • New London, CT
National Provider Identifier
1790062768
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3249 Issued in CT
Practice address
194 Howard St
New London, CT 06320-5544
Phone
(860) 442-0564
NPI assigned
Nov 4, 2011
Last updated
Nov 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3249 CT Primary

Addresses

Primary practice location

194 Howard St
New London, CT 06320-5544

Mailing address

194 Howard St
New London, CT 06320-5544
Phone (860) 442-0564

Other names 1

  • Ellen Faulise 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150219001550 CT Practitioner - Physician Assistant 1355590043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

194 Howard St
New London, CT 06320-5544
Phone (860) 442-0564

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 15, 2016 Accepting new patients
Yale University CurrentSince May 15, 2016 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Oct 13, 2018 Accepting new patients
Total Orthopedic Care Inc PastSince Jul 1, 2005 Accepting new patients

Locations

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

194 Howard St
New London, CT 06320
Phone (860) 442-0564

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: egingerella329558@direct.ynhh.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1790062768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-442-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-442-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGERELLA",
        "first_name": "ELLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "FAULISE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.