Individual provider Active NPI

Marina Sciucco, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1154558385
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
003809 Issued in CT
Practice address
500 Vine St
Hartford, CT 06112-1639
Phone
(860) 297-0854
Fax
(860) 293-6311
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003809 CT Primary

Addresses

Primary practice location

500 Vine St
Hartford, CT 06112-1639

Mailing address

500 Vine St
Hartford, CT 06112-1639
Phone (860) 297-0854

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
I20090908000551 CT Practitioner - Nurse Practitioner 0547315996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

103 S Main St
Middletown, CT 06457-3651
Phone (860) 358-8760

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003809CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Apr 15, 2017 Accepting new patients
Middlesex Hospital CurrentSince Apr 15, 2017 Accepting new patients

Locations

103 S Main St
Middletown, CT 06457
Phone (860) 358-8760

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1154558385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VINE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121639",
            "telephone_number": "860-297-0854",
            "fax_number": "860-293-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121639",
            "telephone_number": "860-297-0854",
            "fax_number": "860-293-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIUCCO",
        "first_name": "MARINA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.