Brian Pervis, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5745 Issued in CT

Practice address

1 Bradley Rd Ste 505
Woodbridge, CT 06525-2292

Phone

(203) 693-1164

Fax

(203) 446-5599

NPI assigned

Jul 2, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brianpervis@direct.practicefusion.com

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.

• Pervis Enterprise LLC

  • Family Nurse Practitioner
  • Woodbridge, CT
  • NPI 1609382134
  Medicare reassignment NPD Authorized official
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1174939839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S JONES BLVD # 1060",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072623",
            "telephone_number": "203-693-1164",
            "fax_number": "888-475-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD STE 505",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252292",
            "telephone_number": "203-693-1164",
            "fax_number": "203-446-5599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Meadow St # 402",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021807",
            "country_code": "US",
            "telephone_number": "203-693-1164",
            "fax_number": "203-446-5599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERVIS",
        "first_name": "BRIAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brianpervis@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "Practice Fusion",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 Straits Tpke Ste 205D",
            "city": "Middlebury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067622800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrycja Marta Pedzinska, MSOTR/L
• Linda Perelberg, LCSW
• Dinesh R Perera, LMFT
• Personal Care Training LLC
• Pervis Enterprise LLC
• Aimee Petremont, BCBA
• Beverley Charmaine Phillips-Lewis, LCSW
• Larissa Ann Phillips, OTR/L
• Taylor Piacentini
• Lesley May Pincince, PT

• Family Nurse Practitioner in Woodbridge, CT
• Providers in Woodbridge, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.