Fair Haven Community Health Clinic Inc - Medicare Dental Clinic in New Haven, CT

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Fair Haven Community Health Clinic Inc is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in New Haven, Connecticut. The current practice location for Fair Haven Community Health Clinic Inc is 374 Grand Ave, New Haven, Connecticut. For appointments, you can reach them via phone at (203) 777-7411. The mailing address for Fair Haven Community Health Clinic Inc is 374 Grand Ave, New Haven, Connecticut and phone number is (203) 777-7411.

Fair Haven Community Health Clinic Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1104803444. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (203) 777-7411.

Contact Information

Fair Haven Community Health Clinic Inc
374 Grand Ave
New Haven
CT 06513
(203) 777-7411
(203) 777-8506

Map and Direction


Dental Care Clinic Profile

Full NameFair Haven Community Health Clinic Inc
SpecialityClinic/Center
Location374 Grand Ave, New Haven, Connecticut
Authorized Official Name and PositionSuzanne Lagarde (CEO)
Authorized Official Contact2037777411
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Fair Haven Community Health Clinic Inc
374 Grand Ave
New Haven
CT 06513

Ph: (203) 777-7411		Fair Haven Community Health Clinic Inc
374 Grand Ave
New Haven
CT 06513

Ph: (203) 777-7411

NPI Details:

NPI Number1104803444
Provider Enumeration Date12/28/2005
Last Update Date10/30/2014

Medicare PECOS Information:

Medicare PECOS PAC ID4183511538
Medicare Enrollment IDO20040302000135

Medical Identifiers

Medical identifiers for Fair Haven Community Health Clinic Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104803444NPI-NPPES
004235736MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice (* (Not Available))Secondary
124Q00000XDental Hygienist (* (Not Available))Secondary
176B00000XMidwife (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Fair Haven Community Health Clinic Inc acts as a billing entity for following providers:
Provider NamePamela L Kwittken
Provider TypePractitioner - Allergy/immunology
Provider IdentifiersNPI Number: 1578530507
PECOS PAC ID: 9234199589
Enrollment ID: I20041012001046
Provider NameHyung Paek
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1730249814
PECOS PAC ID: 1254317027
Enrollment ID: I20041123000099
Provider NameJohn C Mcdonagh
Provider TypePractitioner - Addiction Medicine
Provider IdentifiersNPI Number: 1265430193
PECOS PAC ID: 3678503794
Enrollment ID: I20050818000481
Provider NameJames E Seely
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629065008
PECOS PAC ID: 7618984055
Enrollment ID: I20060309000719
Provider NameBarbara G Orrok
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1639248404
PECOS PAC ID: 1759398480
Enrollment ID: I20060321000364
Provider NameEllen J Wormser
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1043303258
PECOS PAC ID: 7214016476
Enrollment ID: I20080430000143
Provider NameElizabeth A Magenheimer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093819146
PECOS PAC ID: 0042389561
Enrollment ID: I20080522000661
Provider NamePriscilla A Jencks
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1174627236
PECOS PAC ID: 6406928456
Enrollment ID: I20080708000314
Provider NameLaurel B Shader
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1356445415
PECOS PAC ID: 9234207721
Enrollment ID: I20081010000388
Provider NameSakena Abedin
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1891949954
PECOS PAC ID: 8729143409
Enrollment ID: I20090212000184
Provider NameSuzanne P Lagarde
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1114068848
PECOS PAC ID: 0143398792
Enrollment ID: I20090529000300
Provider NameMarybeth Pytlik Ellison
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1609034438
PECOS PAC ID: 6507905502
Enrollment ID: I20091204000247
Provider NameAnne W Camp
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1295702181
PECOS PAC ID: 4082899109
Enrollment ID: I20110504000463
Provider NameRocio Alicea
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1497031181
PECOS PAC ID: 3779743661
Enrollment ID: I20120330000264
Provider NameDeepa Camenga
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1952318214
PECOS PAC ID: 8224291513
Enrollment ID: I20120524000179
Provider NameJennifer B Yaro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316383300
PECOS PAC ID: 9436391513
Enrollment ID: I20130820000891
Provider NameMellisa Pensa
Provider TypePractitioner - Preventive Medicine
Provider IdentifiersNPI Number: 1205096799
PECOS PAC ID: 9830355809
Enrollment ID: I20130926000250
Provider NameOni A Muhammad
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1184024580
PECOS PAC ID: 5698098325
Enrollment ID: I20150102001178
Provider NameLeslie Dimella
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1346226222
PECOS PAC ID: 2668447996
Enrollment ID: I20150326000062
Provider NameKathleen Marie Mcguire
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1235172479
PECOS PAC ID: 3072818277
Enrollment ID: I20160225002572
Provider NameAmanda Decew
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598010407
PECOS PAC ID: 4688811326
Enrollment ID: I20161020001282
Provider NameBenjamin Oldfield
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1831465830
PECOS PAC ID: 3375793862
Enrollment ID: I20161101001759
Provider NameLacey Whitmire
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962847780
PECOS PAC ID: 7618255076
Enrollment ID: I20170608000577
Provider NameLogan Haley Stern
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477091668
PECOS PAC ID: 6204105521
Enrollment ID: I20170629002594
Provider NameBrian M Padilla
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1790215093
PECOS PAC ID: 6901162338
Enrollment ID: I20171117000509
Provider NameKyle T Elligers
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083078695
PECOS PAC ID: 6800180852
Enrollment ID: I20190924002891
Provider NameAnn Jurewicz
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1528224755
PECOS PAC ID: 3072787761
Enrollment ID: I20191122000532
Provider NameCarmen A Betancourt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1891298253
PECOS PAC ID: 5496181166
Enrollment ID: I20200129001331
Provider NameAnna Eisenstein
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1497104822
PECOS PAC ID: 1850689548
Enrollment ID: I20200715003112
Provider NameMario Ochoa Prieto
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407206295
PECOS PAC ID: 6507150877
Enrollment ID: I20201224000631
Provider NameJenna Olenoski
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1134658586
PECOS PAC ID: 3577972843
Enrollment ID: I20210518000401
Provider NameMaranda Gourley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730713512
PECOS PAC ID: 4880093111
Enrollment ID: I20210519000170
Provider NameKarla Tejada-arias
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1104347905
PECOS PAC ID: 7719259365
Enrollment ID: I20210716001268
Provider NameGeorge Ramos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518579804
PECOS PAC ID: 8325445034
Enrollment ID: I20210923000472
Provider NameEmmanuel Martinez Alcaraz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1114486040
PECOS PAC ID: 6901275387
Enrollment ID: I20221206002825
Provider NameChristine Lynn Nay
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225616840
PECOS PAC ID: 3678943842
Enrollment ID: I20230104001305
Provider NameMaybelle E Mercado
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1851432355
PECOS PAC ID: 4183069602
Enrollment ID: I20240223002824
Provider NamePaola Perez
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1518629419
PECOS PAC ID: 3870938137
Enrollment ID: I20240227002373
Provider NameRachel Romero
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063147627
PECOS PAC ID: 0345624847
Enrollment ID: I20240502003380
Provider NameCaitlin Poloukhine
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1144008822
PECOS PAC ID: 8123552692
Enrollment ID: I20241107000540
Provider NameAgustina Fougere
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1003013772
PECOS PAC ID: 5496289449
Enrollment ID: I20241113001659
Provider NameAlexandra Banks
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1982432639
PECOS PAC ID: 7517491368
Enrollment ID: I20241115001378
Provider NameErika Moya
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1871269373
PECOS PAC ID: 0345774097
Enrollment ID: I20241118001071
Provider NameKeyra Scovill
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1235722315
PECOS PAC ID: 9436683117
Enrollment ID: I20241118002384
Provider NameSydney Henck
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1023879319
PECOS PAC ID: 0042745473
Enrollment ID: I20241122000135
Provider NameJennifer Gonzalez-santos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265040208
PECOS PAC ID: 6608301049
Enrollment ID: I20241122000542
Provider NameMarisol Morales
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1689266025
PECOS PAC ID: 1850827650
Enrollment ID: I20241203004057
Provider NameAnabel Quiroz
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1477389021
PECOS PAC ID: 7012443872
Enrollment ID: I20241204001727

Reviews and Comments


Dental Clinics in New Haven, CT


Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1423 Chapel St, Suite 3a, New Haven, CT 06511
Phone: 203-562-0234    Fax: 203-865-2556
Sleepy Smiles Ct Llc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1 Park St, New Haven, CT 06504
Phone: 203-586-1425    
Jack D Berns Dds & Anthony T Dioguardi Dmd
Dental Clinic
Medicare: Medicare Enrolled
Practice Location: 123 York St, Suite 2j, New Haven, CT 06511
Phone: 203-777-2513    Fax: 203-776-1714
Oral And Maxillofacial Surgical Associates, Pc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1423 Chapel St, Third Floor, New Haven, CT 06511
Phone: 203-787-6581    Fax: 203-782-6389
Friends And Family Dental Care
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 419 Whalley Ave, Suite 101, New Haven, CT 06511
Phone: 203-787-0520    
Levy Dental Group, P.c.
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 921 State St, New Haven, CT 06511
Phone: 203-865-2245    Fax: 203-787-1228
Dr.dental Of New Haven, Pc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 122 Amity Road, New Haven, CT 06515
Phone: 203-671-8949    Fax: 203-288-3004

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.