Individual provider Active NPI

Elizabeth Pereira, APRN

  • Family Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1083381966
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9730 Issued in CT
Practice address
1320 W Main St BLDG 2
Waterbury, CT 06708-3131
Phone
(203) 757-8361
Fax
(203) 754-9126
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9730 CT Primary

Addresses

Primary practice location

1320 W Main St BLDG 2
Waterbury, CT 06708-3131

Mailing address

1320 W Main St BLDG 2
Waterbury, CT 06708-3131
Phone (203) 757-8361

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
I20210923001265 CT Practitioner - Nurse Practitioner 6709283435 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9730CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Nov 3, 2022 Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Jun 22, 2021 Accepting new patients
Yale University CurrentSince Nov 3, 2022 Accepting new patients
Yale University Current Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1625 Straits Tpke
Ste 211
Middlebury, CT 06762
Phone (203) 573-9512

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Long Wharf Dr
Ste 503
New Haven, CT 06511
Phone (203) 764-9199

Interoperability endpoints

  • Direct secure messaging: epereira340983@direct.ynhh.org

Organizations & group practices 4

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": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1083381966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST BLDG 2",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083131",
            "telephone_number": "203-757-8361",
            "fax_number": "203-754-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST BLDG 2",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083131",
            "telephone_number": "203-757-8361",
            "fax_number": "203-754-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.