Individual provider Active NPI

Serrita Roper, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Plainville, CT
National Provider Identifier
1194245993
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10765 Issued in CT
Practice address
91 Northwest Dr
Plainville, CT 06062-1534
Phone
(860) 793-3500
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 132009 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10765 CT Primary

Addresses

Primary practice location

91 Northwest Dr
Plainville, CT 06062-1534

Mailing address

45 Robertson St
Bristol, CT 06010-9102

Other practice location 1

11 Edward St
Newington, CT 06111
Phone (860) 665-8129

Other practice location 2

45 Robertson St
Bristol, CT 06010-9102
Phone (860) 938-0349

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
I20221003001490 CT Practitioner - Nurse Practitioner 0648656470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

91 Northwest Dr
Plainville, CT 06062-1534
Phone (860) 793-3500

Hospital & facility affiliations

  • Bristol Hospital Hospital, Bristol, CT, CCN 070029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
132009CTMDRegistered Nurse
10765CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Perspectives Behavioral Health & Wellness, LLC Psychiatric/Mental Health CurrentSince Feb 19, 2023 Accepting new patients

Locations

196 Woodland St
Ste 1
Bristol, CT 06010

Interoperability endpoints

  • Direct secure messaging: serrita.roper.p1@direct.wheelerclinic.nextgenshare.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.

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194245993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ROBERTSON ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060109102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621534",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Edward St",
            "address_purpose": "LOCATION",
            "city": "Newington",
            "state": "CT",
            "postal_code": "06111",
            "country_code": "US",
            "telephone_number": "860-665-8129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Robertson St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060109102",
            "country_code": "US",
            "telephone_number": "860-938-0349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROPER",
        "first_name": "SERRITA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "132009",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "10765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

Verify at the official NPI Registry.