Individual provider Active NPI

Elena Villar Leeman, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Meriden, CT
National Provider Identifier
1164983243
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9944 Issued in CT
Practice address
134 State St
Meriden, CT 06450-3293
Phone
(203) 237-2229
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 7581491 NY
Registered Nurse 163W00000X 179370 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403675 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9944 CT Primary

Addresses

Primary practice location

134 State St
Meriden, CT 06450-3293

Mailing address

134 State St
Meriden, CT 06450-3293
Phone (203) 237-2229

Other practice location 1

55 Westchester Sq
Bronx, NY 10461-3525
Phone (718) 931-4045

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
I20240503001724 CT Practitioner - Nurse Practitioner 3476950585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

134 State St
Meriden, CT 06450-3293
Phone (203) 237-2229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
179370CTMDRegistered Nurse
7581491NYMDRegistered Nurse
403675NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 25, 2024 Accepting new patients
Community Health Center Inc CurrentSince Apr 25, 2024 Accepting new patients

Locations

134 State St
Meriden, CT 06450
Phone (203) 237-2229

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

Interoperability endpoints

  • Direct secure messaging: elena.villarleeman@chcict.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1164983243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503293",
            "telephone_number": "203-237-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503293",
            "telephone_number": "203-237-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Westchester Sq",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104613525",
            "country_code": "US",
            "telephone_number": "718-931-4045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAR LEEMAN",
        "first_name": "ELENA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7581491",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "179370",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403675",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "9944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.