Dilice G Robertson, APRN,PMHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

003973 Issued in CT

Practice address

71 Oxford Rd Unit L
Oxford, CT 06478-1900

Phone

(203) 463-4555

Fax

(203) 517-0058

NPI assigned

Jun 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifespancollaborativeservicesllc.dilicerobertson@158242.advancedmd-direct.com

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.

• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment NPD
• Lifespan Collaborative Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oxford, CT
  • NPI 1013395466
  NPD (past) Authorized official
• Yale University

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

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1497959811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 OXFORD RD UNIT L",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781900",
            "telephone_number": "203-463-4555",
            "fax_number": "203-517-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 OXFORD RD UNIT L",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781900",
            "telephone_number": "203-463-4555",
            "fax_number": "203-517-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "DILICE",
        "middle_name": "G",
        "credential": "APRN,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "81733",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "81733",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CT",
            "license": "81733",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CT",
            "license": "81733",
            "primary": false
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "CT",
            "license": "2008008396",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "003973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonia Rebecca, OTD, OTR/L
• Kaitlyn Remond, OTR/L
• Christina Renzoni, MS, CCC-SLP
• Renee Joyce Richardson, CNA
• Caitlyn Richmond, MSP CCC-SLP
• Robin Mahabir, M.D, P.C
• Robinsoul Wellness, LLC
• Brittney Romagna, MA, LPCA
• Theresa Alecia Rose
• Stacie Rotatori

• Nurse Practitioner in Oxford, CT
• Providers in Oxford, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.