CLARISSE MELINDA FONG SAN JUAN (MD) – Pain Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1245750132
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
126 PAIN MANAGEMENT in CT
Provider Addresses for CLARISSE MELINDA FONG SAN JUAN (MD)
8 Devine St
North Haven, CT 064732172
Phone: (877) 925-3637
Type: Location
659 George St
New Haven, CT 065115324
Phone: (203) 680-7542
Type: Location
111 Goose Ln
Guilford, CT 064375101
Phone: (203) 204-0400
Type: Location
1 Long Wharf Dr Fl 6
New Haven, CT 065115991
Phone: (203) 688-8800
Type: Location
Thomas S. Boyland Street, Brooklyn, Kings County, New York, 11212, United States
BROOKLYN, NY 112332027
Phone:
Type: Mailing
NYC Health + Hospitals/Woodhull, 760, Broadway, Brooklyn, Kings County, New York, 11206, United States
BROOKLYN, NY 112065317
Phone: (718) 963-8000
Type: Location
20 YORK ST
NEW HAVEN, CT 065103220
Phone: (203) 688-4242
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $3,131.
Total Amount is formed as General ($3,131) + Research ($0) + Ownership ($0) = $3,131.
Last reported payment date: 2024-06-07 • Largest payer in this snapshot: Bioventus LLC ($1,018).
Total Amount
$3,131
General + Research + Ownership
Payments
24
Total payment records
General Amount
$3,131
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bioventus LLC | $1,018 |
| Medtronic, Inc. | $948 |
| Abbott Laboratories | $329 |
| Stratus Medical, LLC | $127 |
| Nevro Corp. | $125 |
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: 2023-10-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231019002888 | I | Pain Management | CT | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 25 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 17 | 14 | $0 |
Insurance plans in this area (ZIP 06473)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | CT | |
| H E M A T O L O G Y/ O N C O L O G Y | CT | |
| Internal Medicine, Nephrology | SC | |
| - | CT | |
| - | NC | |
| Internal Medicine | CT | |
| - | CT | |
| Cardiac Surgery | CT | |
| - | CT | |
| - | CT |
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