Rachel Kathleen Girouard
Individual provider Active NPI Nurse Practitioner · Wolcott, CT
NPI 1104602085 · NPPES record last updated Aug 17, 2026
Key facts
- NPI
- 1104602085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AG07230060 (CT)
- Practice address
- 464 Wolcott Rd Ste 3
Wolcott, CT 06716-2663 - Phone
- (203) 879-6171
- Fax
- (203) 879-1191
- NPI assigned
- Sep 6, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Dermatology Center, PC
Practice addresses (Care Compare)
464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231201000510 | CT | Practitioner - Nurse Practitioner | 7719335793 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12375 | CT | MD | Physical Therapist |
| AG07230060 | CT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Dermatology Center, PC | Current |
Accepting new patients | |
| Integrated Dermatology of Waterbury, LLC | Current |
Accepting new patients | |
| Integrated Dermatology of Wolcott PLLC | Past |
Accepting new patients |
Locations
464 Wolcott Rd
Wolcott, CT 06716
Phone (203) 633-4560
464 Wolcott Rd
Ste 3
Wolcott, CT 06716
Phone (203) 879-6171
4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081
Interoperability endpoints
- rachg@jurzyk.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AG07230060 | CT | Yes |
Addresses
Primary practice location
464 Wolcott Rd Ste 3
Wolcott, CT 06716-2663
Mailing address
464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171
Other providers in Wolcott, CT
- Samantha Marie Genovese
- Gericare
- Gericare Psych LLC
- Peter Giacomazzi
- Kayleigh Giannini
- Martin B. Goldstein
- Jeffrey Gonzalez
- Marrhonda Goodwin
- Rachel Gorneault
- Grey Street Counseling Center LLC
All providers in Wolcott, CT · 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 Aug 17, 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.