Samara Ambrosio
Individual provider Active NPI Family Nurse Practitioner · Rocky Hill, CT
NPI 1255700696 · NPPES record last updated Sep 16, 2015
Key facts
- NPI
- 1255700696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 006294 (CT)
- Practice address
- 400 Capital Blvd FL 3
Rocky Hill, CT 06067-3576 - Phone
- (888) 697-9058
- NPI assigned
- Sep 16, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151121000204 | CT | Practitioner - Nurse Practitioner | 4880994995 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Urgent Care Centers, LLC | Current |
Accepting new patients | |
| Hartford Healthcare Medical Group, Inc | Current |
Accepting new patients |
Locations
385 W Main St
Avon, CT 06001
Phone (860) 777-1280
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 006294 | CT | Yes |
Addresses
Primary practice location
400 Capital Blvd FL 3
Rocky Hill, CT 06067-3576
Mailing address
8 Harvest Hill Rd
West Simsbury, CT 06092-2221
Phone (860) 882-8857
Other providers in Rocky Hill, CT
- Jessica Amalfi
- Jadeyn Amara
- Jean Amara
- Gerly Amazan-Rodney
- Ambassador Wheelchair Services
- Jeanne Amenta
- American Health NE, LLC
- Amra Muminovic LLC
- Leah Anderson
- Leah Anderson
All providers in Rocky Hill, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.