Individual provider Active NPI

Sandra E. Charles, APRN

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1417590100
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
00000 Issued in CT
Practice address
1354 Chapel St
New Haven, CT 06511-4420
Phone
(203) 867-8300
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 00000 CT Primary

Addresses

Primary practice location

1354 Chapel St
New Haven, CT 06511-4420

Mailing address

6 Pearl PL
Stratford, CT 06614-2035
Phone (203) 543-3743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210113000165 CT Practitioner - Nurse Practitioner 9133532146 Reassigns benefits to 2 organizations
I20210922000413 MA Practitioner - Nurse Practitioner 9133532146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robinson PA LLCGroup PAC ID 6901062546, 3 clinicians

Practice addresses (Care Compare)

85 Barnes Rd
Suite 201
Wallingford, CT 06492-1832
Phone (203) 626-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8664CTMDSocial Worker
00000CTMDMedical Physician Assistant
RN2263627MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 1, 2021 Accepting new patients
Robinson PA, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452

85 Barnes Rd
Ste 201
Wallingford, CT 06492
Phone (203) 626-5550

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBHFCA/Endpoint/HBHFCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1417590100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PEARL PL",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066142035",
            "telephone_number": "203-543-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114420",
            "telephone_number": "203-867-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "SANDRA",
        "middle_name": "E.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.