Individual provider Active NPI

Alyssa A Anderson, APRN

  • Family Nurse Practitioner
  • Branford, CT
National Provider Identifier
1336421171
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004810 Issued in CT
Practice address
251 W Main St
Branford, CT 06405-4047
Phone
(203) 481-0077
NPI assigned
Sep 19, 2011
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 004810 CT Primary

Addresses

Primary practice location

251 W Main St
Branford, CT 06405-4047

Mailing address

251 W Main St
Branford, CT 06405-4047
Phone (203) 481-0077

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
I20130128000160 CT Practitioner - Nurse Practitioner 9436303518 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4810CTMDPhysician Assistant
004810CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John E. Rivera Jr., M.D., LLC CurrentSince Sep 1, 2020 Accepting new patients
Mark a. Perrotti,M.D.LLC CurrentSince Oct 1, 2012 Accepting new patients
John E. Rivera, M.D., P.C. PastSince Sep 1, 2020 Accepting new patients

Locations

251 W Main St
Branford, CT 06405
Phone (203) 315-5300

251 W Main St
Ste 5
Branford, CT 06405
Phone (203) 481-0077

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1336421171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054047",
            "telephone_number": "203-481-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054047",
            "telephone_number": "203-481-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALYSSA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.