Mikayla Colleen Surina, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13475 Issued in CT

Practice address

950 Yale Ave Ste 39
Wallingford, CT 06492-1884

Phone

(203) 265-9600

NPI assigned

Jul 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mikayla Colleen Fayo Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1285471607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TURKEY HILL RD",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061114424",
            "telephone_number": "845-637-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YALE AVE STE 39",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921884",
            "telephone_number": "203-265-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURINA",
        "first_name": "MIKAYLA",
        "middle_name": "COLLEEN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "13475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAYLA",
            "last_name": "FAYO",
            "middle_name": "COLLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Stuart, BCBA, LBA
• Christopher Sullivan, APRN
• Hilary Sullivan, APRN
• Pei Fang Sun, MD
• Kathryn Nicole Sundberg
• Susan Fagan, LCSW LLC
• SV Opco LLC
• Amanda Swindon, LCSW
• Sameer Syed, M.D.
• Synergy Health and Wellness LLC

• Family Nurse Practitioner in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.