Individual provider Active NPI

Rachael Schaller

  • Family Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1417622333
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.009859 Issued in CT
Practice address
1057 Boston Post Rd
Guilford, CT 06437-2644
Phone
(203) 458-1444
NPI assigned
Aug 12, 2021
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 12.009859 CT Primary

Addresses

Primary practice location

1057 Boston Post Rd
Guilford, CT 06437-2644

Mailing address

1057 Boston Post Rd
Guilford, CT 06437-2644
Phone (203) 458-1444

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
I20211015000526 CT Practitioner - Nurse Practitioner 5294133666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Diagnostic of Connecticut, P.C.Group PAC ID 0941382113, 66 clinicians
Minuteclinic Primary Care Connecticut PLLCGroup PAC ID 0244740645, 4 clinicians

Practice addresses (Care Compare)

1057 Boston Post Rd
Guilford, CT 06437-2644
Phone (866) 389-2727

1057 Boston Post Rd
Suite 2
Guilford, CT 06437-2663
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9859CTMDClinical Social Worker
12.009859CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MC Diagnostic of Connecticut, P.C. Family CurrentSince Sep 1, 2021 Accepting new patients
Minuteclinic Primary Care Connecticut PLLC Family CurrentSince Jun 4, 2025 Accepting new patients
Connecticut CVS Pharmacy, L.L.C. PastSince Aug 15, 2021 Accepting new patients

Locations

3514 Main St
Coventry, CT 06238
Phone (860) 298-5925

1057 Boston Post Rd
Guilford, CT 06437
Phone (203) 458-1444

1057 Boston Post Rd
Ste 2
Guilford, CT 06437
Phone (203) 458-1444

323 Cromwell Ave
Rocky Hill, CT 06067
Phone (860) 384-9666

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1417622333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 BOSTON POST RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372644",
            "telephone_number": "203-458-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 BOSTON POST RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372644",
            "telephone_number": "203-458-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLER",
        "first_name": "RACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.009859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.