Individual provider Active NPI

Corrine Monique Rotas

  • Family Nurse Practitioner
  • Ridgefield, CT
National Provider Identifier
1295537223
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14593 Issued in CT
Practice address
642 Danbury Road
Ridgefield, CT 06877
Phone
(203) 314-1469
NPI assigned
Mar 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14593 CT
Family Nurse Practitioner 363LF0000X 14593 CT Primary

Addresses

Primary practice location

642 Danbury Road
Ridgefield, CT 06877

Mailing address

642 Danbury Rd
Ridgefield, CT 06877-2719
Phone (203) 314-1469

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
I20250416003278 CT Practitioner - Nurse Practitioner 1951826411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

240 Indian River Rd
Suite C
Orange, CT 06477-3649
Phone (203) 497-3861

Hospital & facility affiliations

  • Griffin Hospital Hospital, Derby, CT, CCN 070031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14593CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Health P.C. Nurse Practitioner CurrentSince Mar 14, 2025 Accepting new patients

Locations

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

Organizations & group practices 1

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.

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1295537223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 DANBURY RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068772719",
            "telephone_number": "203-314-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 DANBURY ROAD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "06877",
            "telephone_number": "203-314-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTAS",
        "first_name": "CORRINE",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "14593",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "14593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

Verify at the official NPI Registry.