Active NPI
Sudha Sreenivasan, MD
- Psychiatry Physician
- New Haven, CT
National Provider Identifier
1942367800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 027592CT01
- Practice address
- 34 Park St
Connecticut Mental Health Center
New Haven, CT 06519 - Phone
- (203) 974-7417
- Fax
- (203) 974-7413
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 027592CT01 | CT | Primary |
Addresses
Primary practice location
34 Park St
Connecticut Mental Health Center
New Haven, CT 06519
Mailing address
34 Park St
Office of Care Management Connecticut Mental Health Ctr
New Haven, CT 06519
Phone (203) 974-7417
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027592CT01 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimus Health Care Inc | Current | Accepting new patients | |
| Bridges Healthcare Inc. | Past | Accepting new patients | |
| Child & Family Medical, PLLC | Psychiatry | Past | Accepting new patients |
| Catholic Charities, Inc. - Archdiocese of Hartford | Past | Accepting new patients |
Locations
982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260
471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864
949 Bridgeport Ave
Milford, CT 06460
Phone (203) 301-2308
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/ccaoh/r4/
- https://api.qualifacts.org/api/fhir/bridgesct/r4/
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
- NPI 1669445946
-
- Adult Mental Health Clinic/Center
- Milford, CT
- NPI 1851350300
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milford, CT
- NPI 1124112347
-
- Psychiatry Physician
- White Plains, NY
- NPI 1710008339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942367800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 PARK ST",
"address_2": "OFFICE OF CARE MANAGEMENT CONNECTICUT MENTAL HEALTH CTR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06519",
"telephone_number": "203-974-7417",
"fax_number": "203-974-7413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 PARK ST",
"address_2": "CONNECTICUT MENTAL HEALTH CENTER",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06519",
"telephone_number": "203-974-7417",
"fax_number": "203-974-7413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SREENIVASAN",
"first_name": "SUDHA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "027592CT01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.