Individual provider Active NPI

Michael Palumbo, FNP

  • Family Nurse Practitioner
  • Brookfield, CT
National Provider Identifier
1043037054
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14123 Issued in CT
Practice address
31 Old Route 7
Brookfield, CT 06804-1711
Phone
(860) 650-3848
NPI assigned
Sep 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14123 CT Primary
Family Nurse Practitioner 363LF0000X 354660 NY

Addresses

Primary practice location

31 Old Route 7
Brookfield, CT 06804-1711

Mailing address

31 Old Route 7
Brookfield, CT 06804-1711
Phone (860) 650-3848

Other practice location 1

80 Route 6 Ste 704-705
Baldwin Place, NY 10505-1026
Phone (860) 650-3848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241210003287 NY Practitioner - Nurse Practitioner 2860928157 Reassigns benefits to 2 organizations
I20250324001089 CT Practitioner - Nurse Practitioner 2860928157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Urgent Care Medical of New York LLCGroup PAC ID 5890071443, 40 clinicians

Practice addresses (Care Compare)

31 Old Route 7
Brookfield, CT 06804-1711
Phone (860) 650-3848

80 Route 6
Suite 704 705
Baldwin Place, NY 10505-1026
Phone (860) 650-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
354660NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical of New York, LLC CurrentSince Mar 10, 2025 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 1, 2025 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jan 1, 2025 Accepting new patients
Urgent Care Medical Associates, LLC Family Medicine CurrentSince Mar 10, 2025 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

31 Old Route 7
Brookfield, CT 06804
Phone (203) 262-1911

900 Main St S
Ste 100
Southbury, CT 06488
Phone (203) 262-1911

80 Route 6
Ste 704705
Baldwin Place, NY 10505
Phone (475) 253-2599

19 Bradhurst Ave
Ste 2100N
Hawthorne, NY 10532
Phone (914) 493-8375

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1043037054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711",
            "telephone_number": "860-650-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711",
            "telephone_number": "860-650-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Route 6 Ste 704-705",
            "address_purpose": "LOCATION",
            "city": "Baldwin Place",
            "state": "NY",
            "postal_code": "105051026",
            "country_code": "US",
            "telephone_number": "860-650-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "MICHAEL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-21",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "14123",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.