Individual provider Active NPI

Paul L McCarthy, MD

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1962485185
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
016924 Issued in CT
Practice address
15 York St
DCB - 14a, Dept. of Pediatrics
New Haven, CT 06510-3221
Phone
(203) 688-2470
Fax
(203) 688-7274
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 016924 CT Primary
Pediatric Rheumatology Physician 2080P0216X 016924 CT

Addresses

Primary practice location

15 York St
DCB - 14a, Dept. of Pediatrics
New Haven, CT 06510-3221

Mailing address

15 York St
DCB - 14a, Dept. of Pediatrics
New Haven, CT 06510-3221
Phone (203) 688-2470

Other identifiers 1

IdentifierTypeStateIssuer
001169242MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016924CTMDPediatric Rheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1962485185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "DCB - 14A, DEPT. OF PEDIATRICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-688-2470",
            "fax_number": "203-688-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "DCB - 14A, DEPT. OF PEDIATRICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-688-2470",
            "fax_number": "203-688-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "PAUL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "016924",
            "primary": true
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "CT",
            "license": "016924",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001169242",
            "state": "CT"
        }
    ],
    "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 Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.