Active NPI
Brianna M Marcucio, AUD
- Audiologist
- Branford, CT
National Provider Identifier
1043888431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 284
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 284 | Other | CT | STATE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 284 | CT | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear Nose & Throat Medical and Surgical Group, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FEBFCA
- 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.
-
- Nurse Practitioner
- New Haven, CT
- NPI 1679835086
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.