Dr Michael E Ivy, MD is a medicare enrolled "Surgery - Surgical Critical Care" physician in Wallingford, Connecticut. His current practice location is
50 Gaylord Farm Rd, Wallingford, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 284-2800.
Dr Michael E Ivy is licensed to practice in Connecticut (license number 035224) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780693630.
Physician's Profile
| Full Name | Dr Michael E Ivy |
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| Gender | Male |
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| Speciality | Surgery - Surgical Critical Care |
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| Location | 50 Gaylord Farm Rd, Wallingford, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1780693630
- Provider Enumeration Date: 08/07/2006
- Last Update Date: 09/03/2025
Medicare PECOS Information:
- PECOS PAC ID: 2961485495
- Enrollment ID: I20040608000126
Medical Identifiers
Medical identifiers for Dr Michael E Ivy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1780693630 | NPI | - | NPPES |
| 001352244 | Medicaid | CT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2086S0102X | Surgery - Surgical Critical Care | 035224 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Michael E Ivy allows following entities to bill medicare on his behalf.
| Entity Name | Gaylord Hospital, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730137753 PECOS PAC ID: 1153224191 Enrollment ID: O20040128000878 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michael E Ivy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Michael E Ivy, MD 50 Gaylord Farm Rd, Wallingford, CT 06492-2899 Ph: (203) 284-2800 | Dr Michael E Ivy, MD 50 Gaylord Farm Rd, Wallingford, CT 06492-2899 Ph: (203) 284-2800 |
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