Individual provider Active NPI

Debra Gerson, MD

  • Family Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1912069063
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45111 Issued in CT
Practice address
46 Albion St
Bridgeport, CT 06605-2602
Phone
(203) 330-6000
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45111 CT Primary

Addresses

Primary practice location

46 Albion St
Bridgeport, CT 06605-2602

Mailing address

57 Buena Vista St
Stamford, CT 06907-2402
Phone (203) 940-1823

Other identifiers 1

IdentifierTypeStateIssuer
004234788MedicaidCT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212001822 CT Practitioner - Family Practice 4385639731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 332-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45111CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jan 1, 2025 Accepting new patients
Optimus Health Care Inc CurrentSince May 5, 2017 Accepting new patients
Optimus Health Care Inc CurrentSince May 5, 2017 Accepting new patients
South-West Community Health Center, Inc CurrentSince Jan 13, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jan 1, 2025 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

762 Lindley St
Bridgeport, CT 06606
Phone (203) 576-5131

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

805 Atlantic St
Stamford, CT 06902
Phone (203) 327-5111

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: dgerson756910@direct.ochin.org
  • Direct secure messaging: debra.gerson.1@16244.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1912069063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BUENA VISTA ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069072402",
            "telephone_number": "203-940-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSON",
        "first_name": "DEBRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "45111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004234788",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.