Individual provider Active NPI

Angela Preda, PA

  • Surgical Physician Assistant
  • Bridgeport, CT
National Provider Identifier
1154956878
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4742 Issued in CT
Practice address
2660 Main St Ste 210
Bridgeport, CT 06606-5301
Phone
(203) 576-5708
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4742 CT Primary

Addresses

Primary practice location

2660 Main St Ste 210
Bridgeport, CT 06606-5301

Mailing address

2660 Main St Ste 210
Bridgeport, CT 06606-5301
Phone (203) 576-5708

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
I20210512001944 CT Practitioner - Physician Assistant 1052720570 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 762-5588

Hospital & facility affiliations

  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Feb 1, 2023 Accepting new patients
Yale University CurrentSince Feb 11, 2021 Accepting new patients
Yale University CurrentSince Feb 11, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

2660 Main St
Ste 210
Bridgeport, CT 06606
Phone (203) 334-2246

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

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

20 York St
North Haven, CT 06510
Phone (203) 688-2433

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 5

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 6

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1154956878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST STE 210",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065301",
            "telephone_number": "203-576-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST STE 210",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065301",
            "telephone_number": "203-576-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDA",
        "first_name": "ANGELA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.