Individual provider Active NPI

Salvatore Criscuolo

  • Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1417589656
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8735 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-8031
Phone
(860) 679-4888
Fax
(860) 679-0131
NPI assigned
Feb 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 8735 CT
Nurse Practitioner 363L00000X 8735 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-8031

Mailing address

1000 Asylum Ave Ste 2112
Hartford, CT 06105-1719
Phone (203) 710-7484

Other practice location 1

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

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
I20200406000481 CT Practitioner - Nurse Practitioner 1456780980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Asylum Ave
Suite 2112
Hartford, CT 06105-1719
Phone (860) 714-4749

Hospital & facility affiliations

  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Apr 27, 2020 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Nurse Practitioner CurrentSince Apr 27, 2020 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

1000 Asylum Ave
Ste 2112
Hartford, CT 06105
Phone (860) 714-4749

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Interoperability endpoints

  • Direct secure messaging: scriscuolo2389758@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1417589656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2112",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051719",
            "telephone_number": "203-710-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308031",
            "telephone_number": "860-679-4888",
            "fax_number": "860-679-0131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051208",
            "country_code": "US",
            "telephone_number": "860-714-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISCUOLO",
        "first_name": "SALVATORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-05",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "8735",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.