Individual provider Active NPI

Raeanne Depasquale, APRN

  • Women's Health Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1477698397
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
003550 Issued in CT
Practice address
345 Whitney Ave
New Haven, CT 06511-2348
Phone
(203) 752-2856
Fax
(203) 752-8785
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 003550 CT Primary

Addresses

Primary practice location

345 Whitney Ave
New Haven, CT 06511-2348

Mailing address

345 Whitney Ave
New Haven, CT 06511-2348
Phone (203) 752-2856

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
I20070310000058 CT Practitioner - Nurse Practitioner 0648373761 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003550CTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Southern New England, Inc. CurrentSince Feb 16, 2007 Accepting new patients

Locations

345 Whitney Ave
New Haven, CT 06511
Phone (203) 503-0450

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1477698397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112348",
            "telephone_number": "203-752-2856",
            "fax_number": "203-752-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112348",
            "telephone_number": "203-752-2856",
            "fax_number": "203-752-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPASQUALE",
        "first_name": "RAEANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "003550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.