Elif Ajredini
Individual provider Active NPI Medical Physician Assistant · Waterbury, CT
NPI 1891331591 · NPPES record last updated Nov 28, 2023
Key facts
- NPI
- 1891331591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 6710 (CT)
- Practice address
- 60 Westwood Ave
Waterbury, CT 06708-2460 - Phone
- (203) 574-5997
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- City University of New York School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Interventional Spine and Sports Medicine, PC
Practice addresses (Care Compare)
1579 Straits Tpke
Lowr Level
Middlebury, CT 06762-1835
Phone (203) 598-7246
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240108004497 | CT | Practitioner - Physician Assistant | 9032560693 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6170 | CT | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6170 | CT | |
| Physician Assistant | 363A00000X | 026558 | NY | |
| Medical Physician Assistant | 363AM0700X | 6710 | CT | Yes |
Addresses
Primary practice location
60 Westwood Ave
Waterbury, CT 06708-2460
Mailing address
21 Stieg Ave
Staten Island, NY 10308-1535
Other practice location 1
21 Stieg Ave
Staten Island, NY 10308-1535
Phone (347) 820-4231
Other providers in Waterbury, CT
- Syed Ahamed
- Wessam Naser Ahmed
- Hannah Ahrens
- Caterina Aiello
- Michael Stephen Ajemian
- Trupti Ajudia
- Kyle L Akeley
- Olubusola Akinduro
- Abeera Akram
- A S M Al Amin
All providers in Waterbury, CT · Medical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.