Individual provider Active NPI

Breann Wise

  • Family Nurse Practitioner
  • Milford, CT
National Provider Identifier
1538990171
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.013689 Issued in CT
Practice address
849 Boston Post Rd
Milford, CT 06460-3537
Phone
(877) 925-3637
NPI assigned
Aug 13, 2024
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12.013689 CT Primary

Addresses

Primary practice location

849 Boston Post Rd
Milford, CT 06460-3537

Mailing address

400 Blake St Apt 5107
New Haven, CT 06515-4430
Phone (801) 725-1244

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250423001003 CT Practitioner - Nurse Practitioner 5597291559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

555 Bridgeport Ave
Shelton, CT 06484-4749
Phone (203) 922-1773

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.013689CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Mar 22, 2025 Accepting new patients
Yale University CurrentSince Mar 22, 2025 Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: bwise525557@direct.ynhh.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1538990171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BLAKE ST APT 5107",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065154430",
            "telephone_number": "801-725-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 BOSTON POST RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603537",
            "telephone_number": "877-925-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "BREANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.013689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.