Individual provider Active NPI

Sedhene Robinson, DPA, PA-C

  • Physician Assistant
  • Waterbury, CT
National Provider Identifier
1497283907
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4724 Issued in CT
Practice address
51 N Elm St
Waterbury, CT 06702-1545
Phone
(845) 445-5169
NPI assigned
May 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54428 CA
Physician Assistant 363A00000X 022392 NY
Physician Assistant 363A00000X 4724 CT Primary

Addresses

Primary practice location

51 N Elm St
Waterbury, CT 06702-1545

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417

Other practice location 1

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190425001491 NY Practitioner - Physician Assistant 8628343621 Reassigns benefits to 2 organizations
I20200304000597 CT Practitioner - Physician Assistant 8628343621 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022392NYMDPediatric Occupational Therapist
4724CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Community Health Center Inc CurrentSince Nov 1, 2024 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

51 N Elm St
Waterbury, CT 06702
Phone (203) 574-4000

Interoperability endpoints

  • Direct secure messaging: sedhene.robinson@chcict.eclinicaldirectplus.com

Organizations & group practices 5

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": "1495929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1497283907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N ELM ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021545",
            "telephone_number": "845-445-5169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104592417",
            "country_code": "US",
            "telephone_number": "718-589-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SEDHENE",
        "credential": "DPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-28",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "54428",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022392",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.