Active NPI
Alyssa Marie Nielsen, MD
- Student in an Organized Health Care Education/Training Program
- New Haven, CT
National Provider Identifier
1417659780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 82207
- Practice address
- 34 Park St
New Haven, CT 06519-1109 - Phone
- (203) 444-8879
- NPI assigned
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 82207 | CT | Primary |
Addresses
Primary practice location
34 Park St
New Haven, CT 06519-1109
Mailing address
300 George St Ste 901
New Haven, CT 06511-6662
Phone (203) 785-2095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230626002996 | CT | Order and Referring Only - Psychiatry | 8325406150 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- anielsen617574@direct.ynhh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1417659780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 GEORGE ST STE 901",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065116662",
"telephone_number": "203-785-2095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191109",
"telephone_number": "203-444-8879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "ALYSSA",
"middle_name": "MARIE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "82207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.