Individual provider Active NPI

Rocca L Perruccio, FNP

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1013559624
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8098 Issued in CT
Practice address
428 Columbus Ave
New Haven, CT 06519-1233
Phone
(203) 503-3000
Fax
(203) 503-3224
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8098 CT Primary

Addresses

Primary practice location

428 Columbus Ave
New Haven, CT 06519-1233

Mailing address

400 Columbus Avenue
Credentialing Specialist
New Haven, CT 06519-1233
Phone (203) 503-3000

Other identifiers 1

IdentifierTypeStateIssuer
004235900MedicaidCT

Other names 1

  • Ms. Rocca L Roberto Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1013559624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000",
            "fax_number": "203-503-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000",
            "fax_number": "203-503-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRUCCIO",
        "first_name": "ROCCA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROCCA",
            "last_name": "ROBERTO",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.