CLARISSE MELINDA FONG SAN JUAN MD
NPI 1245750132
Physical Medicine & Rehabilitation - Pain Medicine in New Haven, CT
NPI Status: Active since June 22, 2017
- 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
- Code Navigator
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) |
---|---|---|---|---|
1 | 208100000X | Allopathic & 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. | |||||||||
1 | 2 | 4 | 5 | 7 | 5 | 0 | 1 | 3 | 2 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 8 | 5 | 14 | 5 | 0 | 1 | 6 | |
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 = 2 | 2 |
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 Medicine | 20 YORK ST YNHH SOUTH PAVILION 218 NEW HAVEN, CT 06510 (203) 688-2222 |
1487642153 | KEVIN JOHN BURNS PA C Individual | Physician Assistant | 20 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 Medicine | 20 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 Assistant | 20 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 Medicine | 20 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 Medicine | 20 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 Assistant | 20 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].
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