Individual provider Active NPI

Mindy Anne Milbrun

  • Family Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1235784596
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
356603 Issued in NY
Practice address
564 Black Rock Tpke Unit C
Fairfield, CT 06825-4744
Phone
(203) 554-5949
NPI assigned
Aug 5, 2019
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 356603 NY Primary

Addresses

Primary practice location

564 Black Rock Tpke Unit C
Fairfield, CT 06825-4744

Mailing address

7751 Belfort Pkwy Ste 120
Jacksonville, FL 32256-6921
Phone (904) 372-3943

Other practice location 1

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (904) 372-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250923003443 NY Practitioner - Nurse Practitioner 5991200768 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

Practice addresses (Care Compare)

7751 Belfort Pkwy
Suite 120
Jacksonville, FL 32256-6921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
356603NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Management Partners LLC CurrentSince Nov 1, 2025 Accepting new patients
Diabetes Management Partners LLC CurrentSince Nov 1, 2025 Accepting new patients
Loving Heroes LLC CurrentSince Feb 14, 2021 Accepting new patients

Locations

7751 Belfort Pkwy
Ste 120
Jacksonville, FL 32256

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1235784596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566921",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 BLACK ROCK TPKE UNIT C",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254744",
            "telephone_number": "203-554-5949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILBRUN",
        "first_name": "MINDY",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.