Individual provider Active NPI

Samantha Nebiolo

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1235928565
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
50 Grand Ave
New Haven, CT 06513-3949
Phone
(203) 777-7411
NPI assigned
May 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 197940 CT
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X CT Primary

Addresses

Primary practice location

50 Grand Ave
New Haven, CT 06513-3949

Mailing address

17 Church St
Plantsville, CT 06479-1101
Phone (203) 506-3382

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107002833 CT Practitioner - Certified Nurse Midwife (CNM) 0042700965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 James St
New Haven, CT 06513-4222
Phone (203) 777-7411

164 Grand Ave
New Haven, CT 06513-3938
Phone (203) 777-7411

293 Clinton Ave
New Haven, CT 06513-2814
Phone (203) 777-7411

339 Eastern St
BLDG B
New Haven, CT 06513-2463
Phone (203) 777-7411

35 Wheelbarrow LN
East Haven, CT 06513-2003
Phone (203) 777-7411

374 Grand Ave
New Haven, CT 06513-3733
Phone (203) 777-7411

374 Grand Ave
New Haven, CT 06513-3787

50 Grand Ave
New Haven, CT 06513-3949
Phone (203) 777-7411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
415CTMDChiropractor
197940CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Haven Community Health Clinic, Inc CurrentSince Aug 30, 2025 Accepting new patients
Fair Haven Community Health Clinic Inc Single Specialty Current Accepting new patients
Fair Haven Community Health Clinic, Inc Advanced Practice Midwife CurrentSince Aug 30, 2025 Accepting new patients

Locations

374 Grand Ave
New Haven, CT 06513
Phone (203) 752-5203

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1235928565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CHURCH ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791101",
            "telephone_number": "203-506-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133949",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBIOLO",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "197940",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.