Individual provider Active NPI

Pamela Edie Hoffman, MD

  • Child & Adolescent Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1962647842
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
53080 Issued in CT
Practice address
230 S Frontage Rd # G112
New Haven, CT 06519-1124
Phone
(347) 688-7796
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Informatics Physician 2083C0008X 53080 CT
Child & Adolescent Psychiatry Physician 2084P0804X MD15405 RI
Child & Adolescent Psychiatry Physician 2084P0804X 53080 CT Primary

Addresses

Primary practice location

230 S Frontage Rd # G112
New Haven, CT 06519-1124

Mailing address

230 S Frontage Rd # G112
New Haven, CT 06519-1124
Phone (347) 688-7796

Other identifiers 1

IdentifierTypeStateIssuer
MD15405OtherRIPROFESSIONAL LICENSE

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
I20201201000566 CT Practitioner - Psychiatry 6901167998 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53080CTMDClinical Informatics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Oct 12, 2020 Accepting new patients
Yale University CurrentSince Oct 12, 2020 Accepting new patients

Locations

230 S Frontage Rd
#G112
New Haven, CT 06519
Phone (347) 688-7796

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

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

Interoperability endpoints

  • Direct secure messaging: phoffman319109@direct.ynhh.org

Organizations & group practices 2

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": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1962647842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD # G112",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "347-688-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD # G112",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "347-688-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "PAMELA",
        "middle_name": "EDIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "CT",
            "license": "53080",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD15405",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "53080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "MD15405",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.