Active NPI
Jessica Difabio, APRN
- Primary Care Nurse Practitioner
- New Haven, CT
National Provider Identifier
1508315730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 6664
- Practice address
- 1 Long Wharf Dr
New Haven, CT 06511-5991 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Sep 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 6664 | CT | Primary |
Addresses
Primary practice location
1 Long Wharf Dr
New Haven, CT 06511-5991
Mailing address
1 Long Wharf Dr
New Haven, CT 06511-5991
Phone (203) 781-4600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004217099 | Medicaid | CT | |
| 008056033 | Medicaid | CT | |
| 008056168 | Medicaid | CT | |
| 008039745 | Medicaid | CT | |
| 008068420 | Other | CT | SCHEFILITI MEDICAID # |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161123000517 | CT | Practitioner - Nurse Practitioner | 2264711845 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apt Foundation, Inc | Current | Accepting new patients | |
| Apt Foundation, Inc | Current | Accepting new patients | |
| Apt Foundation Inc | Current | Accepting new patients |
Locations
1 Long Wharf Dr
New Haven, CT 06511
Phone (203) 777-7500
1 Long Wharf Dr
Ste 211
New Haven, CT 06511
Phone (203) 562-6664
1 Long Wharf Dr
Ste 321
New Haven, CT 06511
Phone (203) 781-4600
Organizations & group practices 4
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.
-
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- New Haven, CT
- NPI 1487889655
-
- Methadone Clinic
- Guilford, CT
- NPI 1013734888
-
- Methadone Clinic
- New Haven, CT
- NPI 1104184670
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
- Apt Foundation, Inc
Practice addresses (Care Compare)
1 Long Wharf Dr
New Haven, CT 06511-5991
Phone (203) 781-4640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1508315730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFABIO",
"first_name": "JESSICA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-29",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "6664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004217099",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008056033",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008056168",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008039745",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCHEFILITI MEDICAID #",
"identifier": "008068420",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.