Melissa A Fazzolari, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

7770 Issued in CT

Practice address

270 Main St Ste a
Portland, CT 06480-1836

Phone

(860) 358-5040

Fax

(860) 358-8658

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfazzolari46515@direct.ynhh.org

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.

• MHS Primary Care, Inc

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1336279058
  Medicare reassignment Care Compare group NPD (past)
• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625

  Nurse Practitioner

  Medicare reassignment NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351

  Nurse Practitioner

  Medicare reassignment NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Nurse Practitioner

  Medicare reassignment NPD
• Yale University

  • Health Service Clinic/Center
  • New Haven, CT
  • NPI 1093862740
  Medicare reassignment NPD
• MHS Primary Care

  • Family Medicine Physician
  • Cromwell, CT
  • NPI 1538386420
  NPD
• MHS Primary Care Inc

  • Internal Medicine Physician
  • Essex, CT
  • NPI 1750276655

  Nurse Practitioner

  NPD
• Northeast Medical Group Inc

  • Radiation Oncology Physician
  • Greenwich, CT
  • NPI 1821390626
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Absolute Outcomes, LLC

  • Internal Medicine Physician
  • Monroe, CT
  • NPI 1073746202
  NPD (past)
• Litchfield County Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Torrington, CT
  • NPI 1871513283
  NPD (past)

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1477041564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4870",
            "fax_number": "860-358-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 MAIN ST STE A",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801836",
            "telephone_number": "860-358-5040",
            "fax_number": "860-358-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZOLARI",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7770",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "7770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008082360",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diamond Standard Care
• Diana Abate Schneider, LLC
• Jamie M Dickson, LMSW
• Dr. John L. Mormile Chiropractor LLC
• Julie S. Dudek, LPC
• Morgan Bryant Feshler
• Yiannis Zannis Gazis, DDS
• Peter Gletzakos, DMD
• Donna S. Grisham, LADC
• Wendy Griswold, APRN

• Gerontology Nurse Practitioner in Portland, CT
• Providers in Portland, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.