Individual provider Active NPI

Racquelle Ranan Tugade Thieling, NP

  • Gerontology Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1073160081
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
12.16070 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 12.16070 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

35 Park St
New Haven, CT 06519-1110
Phone (877) 925-3637

Other names 1

  • Racquelle Ranan Tugade Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200924001781 CA Practitioner - Nurse Practitioner 9436578457 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95012539CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Sep 18, 2020 Accepting new patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Sep 18, 2020 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

Organizations & group practices 3

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1073160081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191110",
            "telephone_number": "877-925-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELING",
        "first_name": "RACQUELLE",
        "middle_name": "RANAN TUGADE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12.16070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACQUELLE",
            "last_name": "TUGADE",
            "middle_name": "RANAN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.