David Misiaszek, NP
Individual provider Active NPI Family Nurse Practitioner · Gilman, CT
NPI 1336847003 · NPPES record last updated May 10, 2023
Key facts
- NPI
- 1336847003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 11670 (CT)
- Practice address
- 480 Fitchville Rd
Gilman, CT 06336-1000 - Phone
- (860) 961-4923
- NPI assigned
- Feb 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- HDC Care Solutions LLC
Practice addresses (Care Compare)
101 Centerpoint Dr
Suite 215
Middletown, CT 06457-7568
Phone (888) 964-6681
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230501000557 | CT | Practitioner - Nurse Practitioner | 1759746530 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E55459 | CT | MD | Nurse Practitioner |
| 11670 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Careconnectmd Connecticut PC | Current |
Accepting new patients | |
| HDC Care Solutions, LLC | Nurse Practitioner | Current |
Accepting new patients |
| Healthdrive Medical Services Southeast LLC | Nurse Practitioner | Current |
Accepting new patients |
| Value Based Long Term Care H PC | Current |
Accepting new patients |
Locations
3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182
101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550
5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264
1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000
100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | E55459 | CT | |
| Family Nurse Practitioner | 363LF0000X | 11670 | CT | Yes |
Addresses
Primary practice location
480 Fitchville Rd
Gilman, CT 06336-1000
Mailing address
480 Fitchville Rd
Gilman, CT 06336-1000
Phone (860) 961-4923
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.