Individual provider Active NPI

Brianna M Marcucio, AUD

  • Audiologist
  • Branford, CT
National Provider Identifier
1043888431
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
284 Issued in CT
Practice address
954 Main St
Branford, CT 06405-7727
Phone
(203) 481-0003
Fax
(855) 357-1519
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 284 CT Primary

Addresses

Primary practice location

954 Main St
Branford, CT 06405-7727

Mailing address

31 Broadway
North Haven, CT 06473-2363
Phone (203) 234-1324

Other practice location 1

46 Prince St
New Haven, CT 06519-1600
Phone (203) 752-1726

Other practice location 2

31 Broadway
North Haven, CT 06473-2363
Phone (203) 234-1324

Other identifiers 1

IdentifierTypeStateIssuer
284OtherCTSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
284CTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Medical and Surgical Group, LLC PastSince Feb 28, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEBFCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FEBFCA/Endpoint/FEBFCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1043888431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732363",
            "telephone_number": "203-234-1324",
            "fax_number": "855-496-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064057727",
            "telephone_number": "203-481-0003",
            "fax_number": "855-357-1519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Prince St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191600",
            "country_code": "US",
            "telephone_number": "203-752-1726",
            "fax_number": "855-451-0554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Broadway",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064732363",
            "country_code": "US",
            "telephone_number": "203-234-1324",
            "fax_number": "855-496-0993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUCIO",
        "first_name": "BRIANNA",
        "middle_name": "M",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "284",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.