CLARISSE MELINDA FONG SAN JUAN MD
NPI 1245750132
Physical Medicine & Rehabilitation - Pain Medicine in New Haven, CT

NPI Status: Active since June 22, 2017

Contact Information

20 YORK ST
NEW HAVEN, CT
ZIP 06510
Phone: (203) 688-4242

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  • Individual
  • Female
  • Years of Experience 9
  • Physical Medicine & Rehabilitation
  • Pain Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About CLARISSE MELINDA SAN JUAN

This page provides the complete NPI Profile along with additional information for Clarisse Melinda San Juan, a provider established in New Haven, Connecticut with a medical specialization in Physical Medicine & Rehabilitation, focusing in pain medicine and more than 9 years of experience. She graduated from Loma Linda University School Of Medicine in 2017. The healthcare provider is registered in the NPI registry with number 1245750132 assigned on June 2017. The practitioner's primary taxonomy code is 2081P2900X with license number 72590 (CT). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1245750132
Provider Name
CLARISSE MELINDA FONG SAN JUAN MD
Gender
Female
Entity Type
Individual
Location Address
20 YORK ST NEW HAVEN, CT 06510
Location Phone
(203) 688-4242
Mailing Address
20 YORK ST NEW HAVEN, CT 06510
Mailing Phone
(203) 688-4242
Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2017
Is Sole Proprietor?
Yes
Enumeration Date
06-22-2017
Last Update Date
08-18-2023
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Location Map

Secondary Locations

  • 111 Goose Ln
    Guilford, CT 06437
    (203) 204-0400
  • 659 George St
    New Haven, CT 06511
    (203) 680-7542
  • 1 Long Wharf Dr Fl 6
    New Haven, CT 06511
    (203) 688-8800
  • 8 Devine St
    North Haven, CT 06473
    (877) 925-3637

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation Pain Medicine

Taxonomy Code
2081P2900X
Type
Allopathic & Osteopathic Physicians
License No.
72590
License State
CT
Taxonomy Description
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208100000XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation

72590 (CT)

Medicare Participation & PECOS Enrollment Status

Clarisse Melinda San Juan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Clarisse Melinda San Juan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1759762560

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20231019002888

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for CLARISSE MELINDA FONG SAN JUAN MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245750132
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2285145016
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 1 + 4 + 5 + 0 + 1 + 6 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1245750132 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265437024 MELIH ARICI MD
Individual
Radiology (Diagnostic Radiology)20 YORK ST YALE NEW HAVEN HOSPITAL
NEW HAVEN, CT 06510
(203) 785-7998
1770571440 DAVID CHRISTOPHER CONE MD
Individual
Emergency Medicine20 YORK ST YNHH SOUTH PAVILION 218
NEW HAVEN, CT 06510
(203) 688-2222
1487642153 KEVIN JOHN BURNS PA C
Individual
Physician Assistant20 YORK ST YALE NEW HAVEN HOSPITAL SOUTH PAVILION 218
NEW HAVEN, CT 06510
(203) 688-2222
1992793186 MAURICE J MAHONEY MD
Individual
Medical Genetics (Clinical Genetics (M.D.))20 YORK ST YALE CHILDREN'S HOSPITAL, WEST PAVILION, 2ND FLOOR
NEW HAVEN, CT 06510
(203) 785-2660
1144218207 MARGRETTA R SEASHORE MD
Individual
Medical Genetics (Clinical Genetics (M.D.))20 YORK ST CHILDREN'S HOSPITAL AT YALE, WEST PAVILION, 2ND FLOOR
NEW HAVEN, CT 06510
(203) 785-2660
1689662686 PAUL HENRI DESAN MD
Individual
Psychiatry & Neurology (Psychiatry)20 YORK ST
NEW HAVEN, CT 06510
(203) 688-2619
1073501995 LIVA ANDREJEVA-WRIGHT MD
Individual
Radiology (Diagnostic Radiology)20 YORK ST YALE NEW HAVEN HOSPITAL-SOUTH PAVILLION-2ND FL
NEW HAVEN, CT 06510
(203) 688-2433
1356330104 LAURA JEAN BONTEMPO MD
Individual
Emergency Medicine20 YORK ST YALE-NEW HAVEN CHILDREN'S HOSPITAL-SP 218
NEW HAVEN, CT 06510
(203) 688-2222
1285623082 KELLY ANNETTE MARTENS PA C
Individual
Physician Assistant20 YORK ST YALE NEW HAVEN HOSPTIAL EMERGENCY DEPARTMENT
NEW HAVEN, CT 06510
(203) 688-2222
1528057155 CARLO BRUNO BIFULCO MD
Individual
Pathology (Anatomic Pathology)20 YORK ST YALE-NEW HAVEN CHILDREN'S HOSPITAL-EP 2608
NEW HAVEN, CT 06510
(203) 785-3624
1336138098 KAREN JEAN JUBANYIK-BARBER MD
Individual
Emergency Medicine20 YORK ST YNHH SOUTH PAVILION 218
NEW HAVEN, CT 06510
(203) 688-2222
1558350199 RISA HILLARY KENT MD
Individual
Radiology (Diagnostic Radiology)20 YORK ST YALE NEW HAVEN HOSPITAL SOUTH PAVILION 2ND FLOOR
NEW HAVEN, CT 06510
(203) 688-2433
1194714519 RICHARD TORRES MD
Individual
Pathology (Hematology)20 YORK ST YNHH, CLINIC BUILDING, ROOM 407
NEW HAVEN, CT 06510
(203) 785-2153
1326038860 HARRY C MOSCOVITZ MD
Individual
Emergency Medicine20 YORK ST YNHH SOUTH PAVILION - ROOM 218
NEW HAVEN, CT 06510
(203) 688-2222
1568452969 JOHN E ARUNY MD
Individual
Radiology (Vascular & Interventional Radiology)20 YORK ST YNHH SOUTH PAVILION - 2ND FLOOR
NEW HAVEN, CT 06510
(203) 688-2433
1699765990 ELIZABETH DOLORES BROWNE PAC
Individual
Physician Assistant20 YORK ST YALE NEW HAVEN HOSPITAL
NEW HAVEN, CT 06510
(203) 688-2222
1134110158 MANJU L PRASAD M.D.
Individual
Pathology (Anatomic Pathology)20 YORK ST EP#2-608B
NEW HAVEN, CT 06510
(203) 737-4862
1801887203 MICHAEL EDWIN HODSDON MD
Individual
Pathology (Clinical Pathology/Laboratory Medicine)20 YORK ST YNHH CB 407
NEW HAVEN, CT 06510
(203) 785-2153
1992796387 MARK J SHLOMCHIK MD
Individual
Pathology (Clinical Pathology/Laboratory Medicine)20 YORK ST YNHH, CLINIC BUILDING, ROOM 407
NEW HAVEN, CT 06510
(203) 785-2153
1508857913 HENRY M RINDER MD
Individual
Pathology (Clinical Pathology/Laboratory Medicine)20 YORK ST YNHH - CLINIC BUILDING, ROOM 407
NEW HAVEN, CT 06510
(203) 785-2153

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245750132, enumerated in the NPI registry as an "individual" on June 22, 2017

The provider is located at 20 York St New Haven, Ct 06510 and the phone number is (203) 688-4242

The provider's speciality is Physical Medicine & Rehabilitation with taxonomy code 2081P2900X with a focus in Pain Medicine

The provider has more than 9 years of experience. She graduated from Loma Linda University School Of Medicine in 2017.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

This NPI record was last updated on June 22, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.