Individual provider Active NPI

Mary Ellaine Reyno, NP

  • Family Nurse Practitioner
  • West Haven, CT
National Provider Identifier
1427812924
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13539 Issued in CT
Practice address
1 Cellini PL Ste 102
West Haven, CT 06516-1666
Phone
(203) 932-6481
Fax
(203) 932-4051
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT
Family Nurse Practitioner 363LF0000X 13539 CT Primary

Addresses

Primary practice location

1 Cellini PL Ste 102
West Haven, CT 06516-1666

Mailing address

1 Cellini PL Ste 102
West Haven, CT 06516-1666
Phone (039) 326-4812

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maryellaine.reyno@xdr.hhchealthdirect.org Health Information Exchange (HIE)

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
I20240918002271 CT Practitioner - Nurse Practitioner 5698216646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13539CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1427812924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CELLINI PL STE 102",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161666",
            "telephone_number": "039-326-4812",
            "fax_number": "203-932-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CELLINI PL STE 102",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161666",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNO",
        "first_name": "MARY ELLAINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "13539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maryellaine.reyno@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.