Active NPI
Jan Ehrenwerth, MD
- Anesthesiology Physician
- New Haven, CT
National Provider Identifier
1962486795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 025349
- Practice address
- 20 York St
Ynhh Tompkins Building - 3Rd Floor
New Haven, CT 06510-3220 - Phone
- (203) 785-2802
- Fax
- (203) 785-6664
- NPI assigned
- Dec 5, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 025349 | CT | Primary |
Addresses
Primary practice location
20 York St
Ynhh Tompkins Building - 3Rd Floor
New Haven, CT 06510-3220
Mailing address
PO Box 9805
300 George Street 6TH Floor
New Haven, CT 06536-0805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001253491 | Medicaid | CT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025349 | CT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Past | Accepting new patients |
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.
-
- Health Service Clinic/Center
- New Haven, CT
- NPI 1093862740
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1962486795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9805",
"address_2": "300 GEORGE STREET 6TH FLOOR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065360805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST",
"address_2": "YNHH TOMPKINS BUILDING - 3RD FLOOR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-785-2802",
"fax_number": "203-785-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRENWERTH",
"first_name": "JAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CT",
"license": "025349",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001253491",
"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 Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.