Individual provider Active NPI

Uzochukwu Samuel Ekpunobi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hamden, CT
National Provider Identifier
1174367304
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13364 Issued in CT
Practice address
114 Vineyard Rd
Hamden, CT 06517-1633
Phone
(203) 435-7482
NPI assigned
Jun 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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 13364 CT Primary

Addresses

Primary practice location

114 Vineyard Rd
Hamden, CT 06517-1633

Mailing address

114 Vineyard Rd
Hamden, CT 06517-1633
Phone (203) 435-7482

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
I20240808001473 CT Practitioner - Nurse Practitioner 4183161177 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians
Careteam Health LLCGroup PAC ID 3173906070, 6 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

340 Broad St
Suite 100
Windsor, CT 06095-3030
Phone (860) 483-8836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13364CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Feb 27, 2025 Accepting new patients
State of Connecticut CurrentSince Dec 12, 2024 Accepting new patients
Harvest Healthcare LLC CurrentSince Jul 22, 2024 Accepting new patients
State of Connecticut CurrentSince Dec 12, 2024 Accepting new patients
Careteam Health LLC Psychiatric/Mental Health CurrentSince Jan 22, 2026 Accepting new patients
Hilltop Health and Wellness Psychiatric/Mental Health CurrentSince Aug 10, 2025 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

340 Broad St
Ste 100
Windsor, CT 06095
Phone (860) 483-8836

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 6

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": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1174367304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 VINEYARD RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171633",
            "telephone_number": "203-435-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 VINEYARD RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171633",
            "telephone_number": "203-435-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKPUNOBI",
        "first_name": "UZOCHUKWU",
        "middle_name": "SAMUEL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "13364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.