Organization Active NPI

Preventative Healthcare Solutions LLC

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1528434115
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PREVENTATIVE HEALTHCARE SOLUTIONS LLC
Practice address
80 Elm St
Bridgeport, CT 06604-4115
Phone
(203) 870-8008
Fax
(203) 330-8007
NPI assigned
Aug 18, 2015
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Dr. Noel H Sepulveda, D.C.NPI 1831477975
Title
Owner
Phone
(203) 870-8008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

80 Elm St
Bridgeport, CT 06604-4115

Mailing address

80 Elm St
Bridgeport, CT 06604-4115
Phone (203) 870-8008

Other identifiers 1

IdentifierTypeStateIssuer
D100262848OtherCTMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151211001623 CT Part B Supplier - Clinic/Group Practice 3375844566 Receives reassigned benefits from 2 practitioners
Practice locations: Bridgeport, CT

National Provider Directory

National Provider Directory

Locations

1187 Broad St
Bridgeport, CT 06604
Phone (203) 243-1577

1187 Broad St
Lowr
Bridgeport, CT 06604

80 Elm St
Bridgeport, CT 06604
Phone (203) 870-8008

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1528434115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ELM ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044115",
            "telephone_number": "203-870-8008",
            "fax_number": "203-330-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ELM ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044115",
            "telephone_number": "203-870-8008",
            "fax_number": "203-330-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-870-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D100262848",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.