Nicholas Mudry

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12235 Issued in CT

Practice address

500 W Putnam Ave FL 2
Greenwich, CT 06830-2937

Phone

(877) 925-3637

NPI assigned

Jan 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmudry87119@connecticutchildrens.direct-ci.com
• Direct secure messaging: nmudry345458@direct.ynhh.org

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.

• Yale University

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment Care Compare group NPD
• Connecticut Children'S Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984
  NPD
• Connecticut Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Yale University

  • Health Service Clinic/Center
  • New Haven, CT
  • NPI 1093862740
  NPD (past)

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1326752684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 BROAD ST APT H",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W PUTNAM AVE FL 2",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068302937",
            "telephone_number": "877-925-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRY",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-11",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12235",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "143925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmudry87119@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Move Mountains Wellness LLC
• Anja Elizabeth Mubuuke, LMSW
• Jennifer Mucci-Cruz, OT
• Nicole Mucci, RD, CD-N, CEDS
• Besnik Mucovic, PTA
• Alisa Mujagic, LPC
• David Joshua Mullen, M.D.
• Francis O Mulwodo
• Murphy Medical Associates LLC
• Lucinda Ann Murphy, LCSW

• Family Nurse Practitioner in Greenwich, CT
• Providers in Greenwich, 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 Apr 24, 2026; 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.