Individual provider Active NPI

Caitlin O Harris, APRN

  • Family Nurse Practitioner
  • Trumbull, CT
National Provider Identifier
1487106316
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
006697 Issued in CT
Practice address
112 Quarry Road
Suite 120
Trumbull, CT 06611-4816
Phone
(203) 372-4065
Fax
(203) 372-1644
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 006697 CT Primary

Addresses

Primary practice location

112 Quarry Road
Suite 120
Trumbull, CT 06611-4816

Mailing address

112 Quarry Road
Suite 120
Trumbull, CT 06611-4816
Phone (203) 372-4065

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
I20161219002004 CT Practitioner - Nurse Practitioner 2466733076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

112 Quarry Rd
Suite 120
Trumbull, CT 06611-4877
Phone (203) 372-4065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6697CTMDOccupational Therapist
006697CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jan 9, 2017 Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

112 Quarry Rd
Ste 120
Trumbull, CT 06611
Phone (203) 372-4065

Interoperability endpoints

  • Direct secure messaging: charris354829@direct.ynhh.org

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.

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1487106316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 QUARRY ROAD",
            "address_2": "SUITE 120",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114816",
            "telephone_number": "203-372-4065",
            "fax_number": "203-372-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 QUARRY ROAD",
            "address_2": "SUITE 120",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114816",
            "telephone_number": "203-372-4065",
            "fax_number": "203-372-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CAITLIN",
        "middle_name": "O",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.