Individual provider Active NPI

Michele Lynn Gervase, APRN

  • Family Nurse Practitioner
  • Kent, CT
National Provider Identifier
1467230185
Registry record updated Jul 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07250255 Issued in CT
Practice address
64 Maple St Ste a
Kent, CT 06757-1721
Phone
(860) 419-5925
NPI assigned
Sep 15, 2023
Last updated
Jul 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07250255 CT Primary
Critical Care Medicine Registered Nurse 163WC0200X 176610 CT

Addresses

Primary practice location

64 Maple St Ste a
Kent, CT 06757-1721

Mailing address

64 Maple St Ste a
Kent, CT 06757-1721
Phone (631) 455-9384

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
I20250825003084 CT Practitioner - Nurse Practitioner 8123528031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mobile Care Partners of Connecticut PLLCGroup PAC ID 0547691834, 5 clinicians

Practice addresses (Care Compare)

64 Maple St
Kent, CT 06757-1721
Phone (860) 419-5925

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176610CTMDCritical Care Medicine Registered Nurse
F07250255CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Care Partners of Connecticut PLLC CurrentSince Aug 18, 2025 Accepting new patients

Locations

64 Maple St
Kent, CT 06757
Phone (860) 419-5925

64 Maple St
Ste A
Kent, CT 06757
Phone (860) 419-5925

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21553/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michele.gervase.1@21553.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751760000000",
    "number": "1467230185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MAPLE ST STE A",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067571721",
            "telephone_number": "631-455-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAPLE ST STE A",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067571721",
            "telephone_number": "860-419-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERVASE",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-07-06",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "F07250255",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CT",
            "license": "176610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, CT

Sources for this page

Verify at the official NPI Registry.