Individual provider Active NPI

Destiny R. Grant, N.D., APRN

  • Family Nurse Practitioner
  • Hamden, CT
National Provider Identifier
1306543806
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.013399 Issued in CT
Practice address
1952 Whitney Ave
FL 3
Hamden, CT 06517
Phone
(203) 848-1803
NPI assigned
Feb 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 5.000726 CT
Family Nurse Practitioner 363LF0000X 12.013399 CT Primary

Addresses

Primary practice location

1952 Whitney Ave
FL 3
Hamden, CT 06517

Mailing address

134 Sanford St
Hamden, CT 06514-1700

Other practice location 1

1817 Black Rock Tpke Ste 205
Fairfield, CT 06825-3546
Phone (203) 717-1339

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
I20250211000783 CT Practitioner - Nurse Practitioner 2264962943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Margaret Chustecka Internal Medicine of Greater New HavenGroup PAC ID 3274557152, 30 clinicians

Practice addresses (Care Compare)

1952 Whitney Ave
Hamden, CT 06517-1209
Phone (203) 848-1803

98 Elm St
Suite 4
West Haven, CT 06516-3879
Phone (203) 848-1803

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5.000726CTMDNaturopath
12.013399CTMDFamily Nurse Practitioner
13399CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Margaret Chustecka Internal Medicine of Greater New Haven Family CurrentSince Nov 30, 2024 Accepting new patients

Locations

6 Business Park Dr
Ste 201
Branford, CT 06405
Phone (203) 483-7979

1952 Whitney Ave
Ste 3
New Haven, CT 06517
Phone (203) 288-0129

1952 Whitney Ave
New Haven, CT 06517
Phone (203) 553-7626

385 Main St
West Haven, CT 06516
Phone (203) 848-6710

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 2

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": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1306543806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 SANFORD ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 WHITNEY AVE",
            "address_2": "FL 3",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06517",
            "telephone_number": "203-848-1803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1817 Black Rock Tpke Ste 205",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068253546",
            "country_code": "US",
            "telephone_number": "203-717-1339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DESTINY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "N.D., APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CT",
            "license": "5.000726",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.013399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.