Individual provider Active NPI

Susan Parke, MD

  • Child & Adolescent Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1952440943
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
046077 Issued in CT
Practice address
34 Park St
New Haven, CT 06519
Phone
(203) 974-7300
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 046077 CT Primary

Addresses

Primary practice location

34 Park St
New Haven, CT 06519

Mailing address

34 Park St
New Haven, CT 06519-1109
Phone (505) 272-6225

Other practice location 1

Unm Hospital Psychiatry
2211 Lomas Blvd NE
Albuquerque, NM 87131-0001
Phone (505) 272-6225

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
I20090916000747 CT Practitioner - Psychiatry 1355497397 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of New Mexico School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

34 Park St
New Haven, CT 06519-1109
Phone (860) 418-6617

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046077CTMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Aug 3, 2009 Accepting new patients
Yale University CurrentSince Jul 21, 2019 Accepting new patients
Yale University CurrentSince Jul 21, 2019 Accepting new patients
The Griffin Hospital CurrentSince Jan 2, 2019 Accepting new patients
State of Connecticut CurrentSince Aug 3, 2009 Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

165 Capitol Ave
Ste 2000
Hartford, CT 06106

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

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

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Interoperability endpoints

  • Direct secure messaging: sparke4204@direct.ynhh.org

Organizations & group practices 5

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1952440943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "505-272-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-974-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unm Hospital Psychiatry",
            "address_2": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-6225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKE",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "046077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.