Mary Ellen Pagnozzi, A.P.R.N.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

001588 Issued in CT

Practice address

3 Heron Rd
Mystic, CT 06355-3253

Phone

(860) 536-6442

Fax

(860) 536-6442

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1114943214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HERON RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553253",
            "telephone_number": "860-536-6442",
            "fax_number": "860-536-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HERON RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553253",
            "telephone_number": "860-536-6442",
            "fax_number": "860-536-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGNOZZI",
        "first_name": "MARY ELLEN",
        "name_prefix": "Ms.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "001588",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "001588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004203329",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sari Ann Oliver
• Optimystic LLC (OptiMystic Eye Group)
• Brian Kristofer Owczarski
• Lisa Pacifico, P.T.
• Tyler Curtis Page, D.C.
• Adrienne Lynne Marold Parad, M.D.
• Prior Lewis Parker, MD
• Gaetano Michael Patalano, MHC
• Melissa Paul, DPT
• Sumeet Sanjeev Pawar, M.D.

• Adult Health Nurse Practitioner in Mystic, CT
• Providers in Mystic, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.