Individual provider Active NPI

Larissa Nkouami Pamen, MD

  • Surgery Physician
  • Bristol, CT
National Provider Identifier
1386105278
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
82999 Issued in CT
Practice address
41 Brewster Rd
Bristol, CT 06010-5141
Phone
(860) 585-3966
NPI assigned
Mar 25, 2019
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 82999 CT Primary
Surgery Physician 208600000X 25MA12172800 NJ

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06010-5141

Mailing address

41 Brewster Rd
Bristol, CT 06010-5141
Phone (860) 585-3966

Other names 1

  • Larissa Nkouami Pamen Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002003804 CT Practitioner - General Surgery 5092041269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York at Stony Brook, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12172800NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi Specialty Group, Inc Surgery CurrentSince Oct 1, 2025 Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1386105278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105141",
            "telephone_number": "860-585-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105141",
            "telephone_number": "860-585-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMEN",
        "first_name": "LARISSA",
        "middle_name": "NKOUAMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "82999",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA12172800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "NKOUAMI PAMEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.