Individual provider Active NPI

Brooke Alexis Antonitis, NP

  • Gerontology Nurse Practitioner
  • Danbury, CT
National Provider Identifier
1275471799
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
10.151683 Issued in CT
Practice address
111 Osborne St Ste 121
Danbury, CT 06810-6019
Phone
(203) 739-7038
NPI assigned
Mar 24, 2026
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 10.151683 CT Primary

Addresses

Primary practice location

111 Osborne St Ste 121
Danbury, CT 06810-6019

Mailing address

19 Danbury Rd Apt 9
Ridgefield, CT 06877-4028
Phone (203) 448-6991

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
I20260616002321 CT Practitioner - Nurse Practitioner 0446722946 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)

100 Reserve Rd
Danbury, CT 06810-5212

100 Reserve Rd
Danbury, CT 06810-5267

2921 Northampton St
Bethlehem, PA 18020-5528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10.151683CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Single Specialty CurrentSince Jun 14, 2026 Accepting new patients
Yale University Single Specialty PastSince Jun 14, 2026 Accepting new patients

Locations

111 Osborne St
Ste 121
Danbury, CT 06810
Phone (203) 739-7010

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": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1275471799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DANBURY RD APT 9",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774028",
            "telephone_number": "203-448-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST STE 121",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106019",
            "telephone_number": "203-739-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONITIS",
        "first_name": "BROOKE",
        "middle_name": "ALEXIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "10.151683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.