Individual provider Active NPI

Ann Preston Roselle, ACNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hamden, CT
National Provider Identifier
1407056229
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
004769 Issued in CT
Practice address
60 Washington Ave
Hamden, CT 06518-3271
Phone
(203) 288-0414
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X R176044 MD
Acute Care Nurse Practitioner 363LA2100X AC0004111 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 004769 CT Primary

Addresses

Primary practice location

60 Washington Ave
Hamden, CT 06518-3271

Mailing address

60 Washington Avenue
Hamden, CT 06518
Phone (203) 288-0414

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
I20160413002254 CT Practitioner - Nurse Practitioner 9436327533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornell Scott Hill Health CorporationGroup PAC ID 3072418359, 261 clinicians

Practice addresses (Care Compare)

428 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC0004111MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric and Adult Psychiatry, LLC CurrentSince Feb 1, 2016 Accepting new patients
Cornell Scott Hill Health Corporation CurrentSince Oct 25, 2021 Accepting new patients
Geriatric and Adult Psychiatry, LLC PastSince Feb 1, 2016 Accepting new patients

Locations

60 Washington Ave
Ste 203
Hamden, CT 06518
Phone (203) 288-0414

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

Interoperability endpoints

  • Direct secure messaging: aroselle75548@direct.ynhh.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1407056229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WASHINGTON AVENUE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518",
            "telephone_number": "203-288-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WASHINGTON AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183271",
            "telephone_number": "203-288-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELLE",
        "first_name": "ANN",
        "middle_name": "PRESTON",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MD",
            "license": "R176044",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "AC0004111",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "004769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.