Micah Delbert Richard Ambrose, DO
Individual provider Active NPI Emergency Medicine Physician · Stamford, CT
NPI 1962999482 · NPPES record last updated Mar 16, 2023
Key facts
- NPI
- 1962999482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 70179 (CT)
- Practice address
- 1 Hospital PLZ
Emergency Department
Stamford, CT 06902-3602 - Phone
- (203) 276-7777
- NPI assigned
- Apr 19, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.6 of 100
- Quality
- 89.17
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220420001027 | CT | Practitioner - Emergency Medicine | 7517354640 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70179 | CT | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Physicians of Fairfield County, LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Physicians of New Haven County,LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
32 Strawberry Hill Ct
Stamford, CT 06902
Phone (203) 276-2000
1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925
Interoperability endpoints
- mambrose24206@stamfordhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 70179 | CT | Yes |
Addresses
Primary practice location
1 Hospital PLZ
Emergency Department
Stamford, CT 06902-3602
Mailing address
1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-7777
Other providers in Stamford, CT
- Amanda Hirsch Geffner, LCSW LLC
- Amanda Hirsch-Geffner
- Nicolas Andres Amarante de Napoli
- Louis Paul Amato I
- Miriam Ambalu
- American Current Care PA PC
- Sharon Amir
- Amsurg Stamford Anesthesia LLC
- Amy Albero LLC
- Elizabeth Anavy
All providers in Stamford, CT · Emergency Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.