Individual provider Active NPI

Samara Ambrosio

  • Family Nurse Practitioner
  • Rocky Hill, CT
National Provider Identifier
1255700696
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
006294 Issued in CT
Practice address
400 Capital Blvd FL 3
Rocky Hill, CT 06067-3576
Phone
(888) 697-9058
NPI assigned
Sep 16, 2015
Last updated
Sep 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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 006294 CT Primary

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

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
I20151121000204 CT Practitioner - Nurse Practitioner 4880994995 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc CurrentSince Aug 1, 2017 Accepting new patients
Hartford Healthcare Urgent Care Centers, LLC CurrentSince Nov 26, 2017 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

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, 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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1255700696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HARVEST HILL RD",
            "city": "WEST SIMSBURY",
            "state": "CT",
            "postal_code": "060922221",
            "telephone_number": "860-882-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD FL 3",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "888-697-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIO",
        "first_name": "SAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

Verify at the official NPI Registry.