Individual provider Active NPI

Valeria McInnis, FNP-BC

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1215884572
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16925 Issued in CT
Practice address
4697 Main St
Bridgeport, CT 06606-1869
Phone
(203) 366-0664
NPI assigned
Mar 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16925 CT Primary

Addresses

Primary practice location

4697 Main St
Bridgeport, CT 06606-1869

Mailing address

200 Yale St
Roslyn Heights, NY 11577-2454
Phone (210) 848-9990

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
I20260521002457 CT Practitioner - Nurse Practitioner 1254801053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

345 Whitney Ave
New Haven, CT 06511-2348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16925CTMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1773446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1215884572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 YALE ST",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772454",
            "telephone_number": "210-848-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4697 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061869",
            "telephone_number": "203-366-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "VALERIA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "16925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.