Foluke R Bamisile
Individual provider Active NPI Family Nurse Practitioner · Shelton, CT
NPI 1053243188 · NPPES record last updated Jun 2, 2026
Key facts
- NPI
- 1053243188
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 17521 (CT)
- Practice address
- 61 Bridgeport Ave
Shelton, CT 06484-3285 - Phone
- (203) 913-5946
- NPI assigned
- Jun 2, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proactive Health Care Management LLC
Practice addresses (Care Compare)
1145 Poquonnock Rd
Groton, CT 06340-4620
Phone (860) 446-9960
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17521 | CT | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17521 | CT | Yes |
Addresses
Primary practice location
61 Bridgeport Ave
Shelton, CT 06484-3285
Mailing address
61 Bridgeport Ave
Shelton, CT 06484-3285
Other providers in Shelton, CT
- Fabiola Sara Balarezo
- Brittany Balducci
- Beth A Balko
- Jillian Ingrid Ball
- Dammy Bamisile
- Grace Dolores Bandow
- Daisy H Bang
- Joseph William Barbar
- Vanessa L Barber
- Elaine Barclay
All providers in Shelton, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.