Sandra Michelle Sudduth, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

9818 Issued in CT

Practice address

950 Campbell Ave
West Haven, CT 06516-2770

Phone

(203) 932-5711

NPI assigned

Jul 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Impact Health P.C.

  • Nurse Practitioner
  • Orange, CT
  • NPI 1730694316
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1386317550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MONHEGE PATH",
            "city": "MARLBOROUGH",
            "state": "CT",
            "postal_code": "064471125",
            "telephone_number": "203-915-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "SANDRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "E52898",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "9818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Ilona Straub, M.D.
• Katharine Grace Straw, MSN, APRN, NP-C
• Patricia F. Strilbyckij, RPH
• Charles Robert Sturwold, RPH
• Liana Suarez
• John Joseph Sullivan, MSW
• Ryan Edward Sullivan, LCSW
• Meghan Justine Sumner
• Courtney Ann Sura, APRN
• Richard Sutton, MD

• Primary Care Nurse Practitioner in West Haven, CT
• Providers in West Haven, CT by specialty
• Primary Care Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2021; 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.