Individual provider Active NPI

Alimatu A Busari, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1073235172
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11157 Issued in CT
Practice address
15 Johnson St
Middletown, CT 06457-2224
Phone
(860) 538-8031
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 086227 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11157 CT Primary

Addresses

Primary practice location

15 Johnson St
Middletown, CT 06457-2224

Mailing address

15 Johnson St
Middletown, CT 06457-2224
Phone (860) 538-8031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230405002905 CT Practitioner - Nurse Practitioner 5799150652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Wellness Behavioral Health Outreach IncGroup PAC ID 1951796119, 16 clinicians

Practice addresses (Care Compare)

415 Main St
West Haven, CT 06516-4296
Phone (203) 931-1184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086227CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Wellness Center, LLC. CurrentSince Sep 11, 2024 Accepting new patients
Step Up Care PC LLC CurrentSince Mar 15, 2023 Accepting new patients
Shoreline Wellness Behavioral Health Outreach Inc CurrentSince Sep 11, 2024 Accepting new patients

Locations

33 Lincoln Ave
Danbury, CT 06810
Phone (203) 797-9300

415 Main St
Lowr
West Haven, CT 06516

415 Main St
West Haven, CT 06516
Phone (203) 931-1184

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1073235172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 JOHNSON ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572224",
            "telephone_number": "860-538-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 JOHNSON ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572224",
            "telephone_number": "860-538-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSARI",
        "first_name": "ALIMATU",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "086227",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "11157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.