Individual provider Active NPI

Roseanne Meyer Martinez, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1396520730
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12263 Issued in CT
Practice address
2099 Durham Rd
Guilford, CT 06437-1677
Phone
(860) 287-3499
NPI assigned
Aug 24, 2023
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12263 CT Primary
Nurse Practitioner 363L00000X 12263 CT

Addresses

Primary practice location

2099 Durham Rd
Guilford, CT 06437-1677

Mailing address

2099 Durham Rd
Guilford, CT 06437-1677
Phone (860) 287-3499

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
I20231106002832 CT Practitioner - Nurse Practitioner 1658728118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians
Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Suite 309
Farmington, CT 06032-1953
Phone (860) 677-5570

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12263CTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc Psychiatric/Mental Health CurrentSince Oct 1, 2023 Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

Organizations & group practices 2

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1396520730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 DURHAM RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371677",
            "telephone_number": "860-287-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 DURHAM RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371677",
            "telephone_number": "860-287-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER MARTINEZ",
        "first_name": "ROSEANNE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12263",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "12263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.