Active NPI
John T Fahey, MD
- Pediatric Cardiology Physician
- New Haven, CT
National Provider Identifier
1851374086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 024404
- Practice address
- 20 York St
Ynhh (Children'S) West Pavilion 2ND Floor
New Haven, CT 06510-3220 - Phone
- (203) 785-4081
- Fax
- (203) 737-2786
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 024404 | CT | Primary |
Addresses
Primary practice location
20 York St
Ynhh (Children'S) West Pavilion 2ND Floor
New Haven, CT 06510-3220
Mailing address
PO Box 9805
300 George Street 6TH Floor
New Haven, CT 06536-0805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001244045 | Medicaid | CT |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024404 | CT | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current | Accepting new patients | |
| Yale University | Current | Accepting new patients | |
| Eastern Conn. Cardiology Group | Past | Accepting new patients | |
| Eastern CT Cardiology Diagnostics, LLC | Past | Accepting new patients |
Locations
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
20 York St
North Haven, CT 06510
Phone (203) 688-2433
Interoperability endpoints
- john.fahey@xdr.hhchealthdirect.org
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1851374086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9805",
"address_2": "300 GEORGE STREET 6TH FLOOR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065360805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST",
"address_2": "YNHH (CHILDREN'S) WEST PAVILION 2ND FLOOR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-785-4081",
"fax_number": "203-737-2786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHEY",
"first_name": "JOHN",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "CT",
"license": "024404",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001244045",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
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 Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.