Individual provider Active NPI

Carroll Nsubuga-Ruzbasan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1285187781
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6580 Issued in CT
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(866) 799-5886
NPI assigned
Aug 1, 2016
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6580 CT Primary
Primary Care Nurse Practitioner 363LP2300X 12.006580 CT

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

324 Elm St
Suite 202B
Monroe, CT 06468-2280
Phone (203) 880-5335

Other names 1

  • Carroll Nsubuga Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carroll.nsubuga-ruzbasan@optum.com Health Information Exchange (HIE)

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
I20161101000158 CT Practitioner - Nurse Practitioner 1557649233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians
Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Suite 309
Farmington, CT 06032-1953
Phone (860) 677-5570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.006580CTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc Psychiatric/Mental Health CurrentSince Dec 25, 2023 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1285187781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 ELM ST",
            "address_2": "SUITE 202B",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682280",
            "telephone_number": "203-880-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "866-799-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSUBUGA-RUZBASAN",
        "first_name": "CARROLL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "6580",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "12.006580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carroll.nsubuga-ruzbasan@optum.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9900 Bren Rd E",
            "city": "Minnetonka",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553439664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARROLL",
            "last_name": "NSUBUGA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.