Individual provider Active NPI

Marc Salvatore D'Amato, PA-C

  • Surgical Physician Assistant
  • New Haven, CT
National Provider Identifier
1790712529
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
000518 Issued in CT
Practice address
1450 Chapel St
Dept of Surgery
New Haven, CT 06511-4405
Phone
(203) 789-3601
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 000518 CT Primary

Addresses

Primary practice location

1450 Chapel St
Dept of Surgery
New Haven, CT 06511-4405

Mailing address

27 Rosemary CT
Middlefield, CT 06455-1224
Phone (860) 349-4016

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
I20070515000249 CT Practitioner - Physician Assistant 2062519705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000518CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince Dec 7, 2012 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Dec 7, 2012 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients
Hospital of Saint Raphael Past Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

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

Interoperability endpoints

  • Direct secure messaging: mdamato100269@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 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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790712529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ROSEMARY CT",
            "city": "MIDDLEFIELD",
            "state": "CT",
            "postal_code": "064551224",
            "telephone_number": "860-349-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "address_2": "DEPT OF SURGERY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMATO",
        "first_name": "MARC",
        "middle_name": "SALVATORE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "000518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.