NPIMap

Individual provider Active NPI

Lacretia Watts

  • Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1538801188
Registry record updated Mar 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10299 Issued in CT
Practice address
1055 Townsend Ave
New Haven, CT 06512-1954
Phone
(203) 710-2779
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10299 CT Primary

Addresses

Primary practice location

1055 Townsend Ave
New Haven, CT 06512-1954

Mailing address

184 Liberty St
New Haven, CT 06519-1625
Phone (203) 214-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114001568 CT Practitioner - Nurse Practitioner 9133576069 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

163 Quinnipiac Ave
North Haven, CT 06473-3623
Phone (203) 624-3303

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 679-3553

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Medical Group Inc CurrentSince Mar 1, 2026 Accepting new patients
Comprehensive Rehab Consultants PLLC Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Careconnectmd Connecticut PC CurrentSince Nov 1, 2023 Accepting new patients
Northeast Medical Group, Inc. Nurse Practitioner CurrentSince Jan 26, 2025 Accepting new patients
Northeast Medical Group Inc CurrentSince Jan 26, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500

184 Liberty St
New Haven, CT 06519
Phone (203) 688-9704

163 Quinnipiac Ave
North Haven, CT 06473
Phone (203) 624-3303

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000

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

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

1 Emily Way
West Hartfrd, CT 06107
Phone (860) 561-7022

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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.

Hospital & facility affiliations 10

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678492800000",
    "number": "1538801188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 LIBERTY ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191625",
            "telephone_number": "203-214-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 TOWNSEND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065121954",
            "telephone_number": "203-710-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "LACRETIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2023-03-11",
        "certification_date": "2023-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.