Individual provider Active NPI

Beatrice Home Vincent

  • Nurse Practitioner
  • East Haven, CT
National Provider Identifier
1457161663
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14017 Issued in CT
Practice address
317 Foxon Rd
East Haven, CT 06513-2038
Phone
(475) 441-7809
NPI assigned
Jan 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14017 CT
General Practice Registered Nurse 163WG0000X 14017 CT
General Practice Physician 208D00000X 14017 CT
Nurse Practitioner 363L00000X 14017 CT Primary

Addresses

Primary practice location

317 Foxon Rd
East Haven, CT 06513-2038

Mailing address

283 Mount Fair Dr
Watertown, CT 06795-1657
Phone (203) 224-9376

Other practice location 1

279 Chase Ave
Waterbury, CT 06704-2236
Phone (203) 528-4993

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
I20260324003216 CT Practitioner - Nurse Practitioner 9335623651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CT Medical Group Inc.Group PAC ID 9739663105, 35 clinicians

Practice addresses (Care Compare)

279 Chase Ave
Waterbury, CT 06704-2236
Phone (203) 528-4993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Docs Urgent and Primary Care Nurse Practitioner CurrentSince Jan 12, 2025 Accepting new patients

Locations

279 Chase Ave
Waterbury, CT 06704
Phone (203) 573-8577

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": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1457161663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 MOUNT FAIR DR",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951657",
            "telephone_number": "203-224-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 FOXON RD",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065132038",
            "telephone_number": "475-441-7809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 Chase Ave",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067042236",
            "country_code": "US",
            "telephone_number": "203-528-4993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BEATRICE",
        "middle_name": "HOME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "14017",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CT",
            "license": "14017",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "14017",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "14017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

Verify at the official NPI Registry.