AMBER BLUE (M.D.) – Psychiatry Physician, NPI 1124415484

AMBER BLUE (M.D.) is a healthcare provider. based in New haven, Connecticut. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. 300138 (NY). The NPI Number for AMBER BLUE (M.D.) is 1124415484

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
AMBER BLUE (M.D.)
NPI
1124415484
Phone
(203) 785-2095
Address
300 GEORGE ST STE 901
Enumeration Date
23 April 2015
Last Update Date
26 October 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
8333518255
Graduation Year
2015 (11 years ago)
PAC ID
4385956523
Group Practice PAC ID
4082049036
Professional Enrollment ID
I20220726002535
Address ID
NY100016208NE109XXSTXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:11State licenses:2Digital endpointsOther names

851 PSYCHIATRY in CT

Provider Addresses for AMBER BLUE (M.D.)

  • 300 GEORGE ST STE 901

    NEW HAVEN, CT 065116662

    Phone: (203) 785-2095

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220726001245IPsychiatryCTTBD
I20220726002535IPsychiatryNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082049036View full group profile
NameSpecialtyState
P S Y C H I A T R YNY
P S Y C H I A T R YNY
P S Y C H I A T R YNY
Mental Health CounselorNY
Mental Health CounselorNY
P S Y C H I A T R YNY
P S Y C H I A T R YNY
-AK
Mental Health CounselorNY
P S Y C H I A T R YNY

Reviews

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Frequently asked questions

What NPI should I save for AMBER BLUE (M.D.)?
Save NPI 1124415484 if you need a stable reference for AMBER BLUE (M.D.).
Is AMBER BLUE (M.D.)'s NPI currently valid?
The extract we use shows AMBER BLUE (M.D.) as active.
What field does AMBER BLUE (M.D.) work in?
You can think of AMBER BLUE (M.D.) as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What location shows for AMBER BLUE (M.D.)?
We surface New Haven, Connecticut for AMBER BLUE (M.D.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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