NPIMap

Organization Active NPI

Yale University

Doing business as Yale Medicine

  • Durable Medical Equipment & Medical Supplies
  • New Haven, CT
National Provider Identifier
1912040205
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
025346 Issued in CT
Legal business name
YALE UNIVERSITY
Doing business as
Yale Medicine
Practice address
800 Howard Ave
New Haven, CT 06519-1369
Phone
(203) 785-2140
Fax
(203) 785-6414
NPI assigned
Feb 15, 2007
Last updated
May 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Iain Burchell
Title
Chief Financial Officer
Phone
(203) 785-2140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 025346 CT Primary

Addresses

Primary practice location

800 Howard Ave
New Haven, CT 06519-1369

Mailing address

PO Box 7309
New Haven, CT 06519-0309
Phone (203) 785-2140

Other names 1

  • YALE MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930056795 CT DME Supplier - Physician - Orthopedic/Orthopedic Surgery 9436061736 Practice locations: New Haven, CT

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2138260Yale Internal Medicine Assoc of Yale Med Administr800 Howard Ave, 1St Floor, New Haven, CT 06519Certificate of waiverOct 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Raj Modak MD25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

Use Cb9333
Hartford, CT 06150

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mga HomecareScottsdale, AZ, CCN 037243 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecareColorado Springs, CO, CCN 067487 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecareGlendale, CO, CCN 067522 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecareAustin, TX, CCN 748009 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecarePueblo, CO, CCN 067584 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecareAddison, TX, CCN 748028 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 12, 2020
Mga HomecareMemphis, TN, CCN 447825 Home health agency 5% Or Greater Indirect Ownership Interest (11.05%) Feb 4, 2022

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1912040205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7309",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065190309",
            "telephone_number": "203-785-2140",
            "fax_number": "203-785-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2140",
            "fax_number": "203-785-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YALE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "BURCHELL",
        "authorized_official_first_name": "IAIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "203-785-2140"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "025346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YALE MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YALE MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.