Individual provider Active NPI

Andrew Yim

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1902874530
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
002945 Issued in CT
Practice address
400 Columbus Ave
New Haven, CT 06519-1233
Phone
(203) 503-3250
Fax
(203) 503-3254
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 002945 CT Primary

Addresses

Primary practice location

400 Columbus Ave
New Haven, CT 06519-1233

Mailing address

400 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3250

Other identifiers 1

IdentifierTypeStateIssuer
004235900MedicaidCT

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
I20031204000434 CT Practitioner - Nurse Practitioner 3870498611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center Inc 149 clinicians

Practice addresses (Care Compare)

134 State St
Meriden, CT 06450-3293
Phone (203) 237-2229

Hospital & facility affiliations

  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002945CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 26, 2024 Accepting new patients
Community Health Center Inc Current Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott-Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients
Cornell Scott Hill Health Corporation PastSince Jan 1, 1990 Accepting new patients

Locations

134 State St
Meriden, CT 06450
Phone (203) 237-2229

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

Interoperability endpoints

  • Direct secure messaging: andrew.yim@chcict.eclinicaldirectplus.com

Organizations & group practices 28

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.

View all 28

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1902874530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3250",
            "fax_number": "203-503-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3250",
            "fax_number": "203-503-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.