Individual provider Active NPI

Brittany Giammalvo, RPA-C

  • Physician Assistant
  • Old Saybrook, CT
National Provider Identifier
1033426200
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4808 Issued in CT
Practice address
455 Boston Post Rd Ste 10
Old Saybrook, CT 06475-1554
Phone
(860) 388-9799
Fax
(860) 388-6646
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4808 CT Primary

Addresses

Primary practice location

455 Boston Post Rd Ste 10
Old Saybrook, CT 06475-1554

Mailing address

455 Boston Post Rd Ste 10
Old Saybrook, CT 06475-1554
Phone (860) 388-9799

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brittany@saybrookdermatology.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200601002669 CT Practitioner - Physician Assistant 3476974361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saybrook Dermatology LLCGroup PAC ID 4688663248, 5 clinicians

Practice addresses (Care Compare)

455 Boston Post Rd
Suite 10
Old Saybrook, CT 06475-1554
Phone (860) 388-9799

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4808CTMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bgiammalvo@saybrookdermatology.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1033426200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 BOSTON POST RD STE 10",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751554",
            "telephone_number": "860-388-9799",
            "fax_number": "860-388-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 BOSTON POST RD STE 10",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751554",
            "telephone_number": "860-388-9799",
            "fax_number": "860-388-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIAMMALVO",
        "first_name": "BRITTANY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brittany@saybrookdermatology.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "brittany@saybrookdermatology.emadirect.md",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "455 Boston Post Rd Ste 10",
            "city": "Old Saybrook",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064751554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.