Individual provider Active NPI

Sydney Royer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Willimantic, CT
National Provider Identifier
1457059958
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12.011664 Issued in CT
Practice address
289 Windham Rd
Willimantic, CT 06226-3528
Phone
(203) 634-7020
NPI assigned
Feb 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.011664 CT Primary

Addresses

Primary practice location

289 Windham Rd
Willimantic, CT 06226-3528

Mailing address

65 Horse Pond Rd Apt G
Salem, CT 06420-4039
Phone (860) 303-7100

Other practice location 1

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Other practice location 2

1250 Silver St
Middletown, CT 06457-3946
Phone (860) 852-1064

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
I20230707000114 CT Practitioner - Nurse Practitioner 0446619597 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11664CTMDSocial Worker
12.011664CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Mind and Wellness Psychiatric/Mental Health Current Accepting new patients
Rushford Center, Inc. CurrentSince Jun 1, 2023 Accepting new patients

Locations

883 Paddock Ave
Meriden, CT 06450
Phone (203) 630-5220

1250 Silver St
Middletown, CT 06457
Phone (860) 346-0300

Interoperability endpoints

  • Direct secure messaging: sydney.royer@xdr.hhchealthdirect.org

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": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1457059958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HORSE POND RD APT G",
            "city": "SALEM",
            "state": "CT",
            "postal_code": "064204039",
            "telephone_number": "860-303-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 WINDHAM RD",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263528",
            "telephone_number": "203-634-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Montauk Ave",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204700",
            "country_code": "US",
            "telephone_number": "860-442-0711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 Silver St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064573946",
            "country_code": "US",
            "telephone_number": "860-852-1064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROYER",
        "first_name": "SYDNEY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.011664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.