Reginal Predestin, OWNER

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

250 N Bishop Ave Apt 2
Bridgeport, CT 06610-2455

Phone

(203) 572-6065

NPI assigned

Mar 19, 2022

Last updated

Mar 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pre-Destination Elderly & Handicap LLC

  • Non-emergency Medical Transport (VAN)
  • Bridgeport, CT
  • NPI 1760131528
  NPD Authorized official

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

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647648000000",
    "number": "1306595244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N BISHOP AVE APT 2",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102455",
            "telephone_number": "203-572-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N BISHOP AVE APT 2",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102455",
            "telephone_number": "203-572-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDESTIN",
        "first_name": "REGINAL",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Pratt, LMSW
• Pre-Destination Elderly & Handicap LLC
• Kathleen Regina Prece, LCSW
• Precise Care, LLC
• Angela Preda, PA
• Claudia Preisick, LPC
• Robert Preli, M.A., MFT
• Premise Health of Connecticut Medical, P.C. (The Wellness Center Operated by Premise Health)
• Carole M Presnick, M.D.
• Preventative Healthcare Solutions LLC

• Contractor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Contractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.