Individual provider Active NPI

Eugene Guild Sheffield, MD

  • Pediatric Radiology Physician
  • New Haven, CT
National Provider Identifier
1942264684
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
H5967 Issued in TX
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 200-5180
Fax
(203) 200-5170
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X H5967 TX Primary
Diagnostic Radiology Physician 2085R0202X H5967 TX

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

275 Winchester Avenue
#347
New Haven, CT 06511-1917
Phone (214) 636-1997

Other identifiers 1

IdentifierTypeStateIssuer
125561405MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20151221001857 TN Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 9931257524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Pediatric Medicine
Education
University of Mississippi School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

848 Adams Ave
Memphis, TN 38103-2816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H5967TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatric Radiology CurrentSince Jan 1, 2016 Accepting new patients

Locations

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: esheffield25979@mlh.direct-ci.com

Organizations & group practices 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1942264684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 WINCHESTER AVENUE",
            "address_2": "#347",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111917",
            "telephone_number": "214-636-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-200-5180",
            "fax_number": "203-200-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFFIELD",
        "first_name": "EUGENE",
        "middle_name": "GUILD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "H5967",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H5967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125561405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.