Active NPI
Magdalena Szczerbacki, APRN
- Primary Care Nurse Practitioner
- West Haven, CT
National Provider Identifier
1417678657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 12.010961
- Practice address
- 950 Campbell Ave
West Haven, CT 06516-2770 - Phone
- (866) 808-7921
- NPI assigned
- Sep 6, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 12.010961 | CT | Primary |
Addresses
Primary practice location
950 Campbell Ave
West Haven, CT 06516-2770
Mailing address
68 Old Mill Rd
Plantsville, CT 06479-1435
Phone (860) 930-3644
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231027001591 | CT | Order and Referring Only - Nurse Practitioner | 3971959909 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10961 | CT | MD | Physical Therapist |
| 12.010961 | CT | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1417678657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 OLD MILL RD",
"city": "PLANTSVILLE",
"state": "CT",
"postal_code": "064791435",
"telephone_number": "860-930-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "866-808-7921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SZCZERBACKI",
"first_name": "MAGDALENA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-06",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "12.010961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.