Amanda Decew, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

005069 Issued in CT

Practice address

374 Grand Ave
Fair Haven Community Health Center
New Haven, CT 06513-3733

Phone

(203) 777-7411

NPI assigned

Jul 17, 2012

Last updated

Jul 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adecew340244@direct.ynhh.org

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.

• Fair Haven Community Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1104803444
  NPD
• Fair Haven Community Health Clinic Inc.

  dba Fair haven Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1871770768
  NPD
• Fair Haven Community Health Clinic, Inc

  dba Grand Pharmacy

  • Community/Retail Pharmacy
  • Branford, CT
  • NPI 1760051486
  NPD
• Sunflower Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Essex, CT
  • NPI 1912794264
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1598010407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "address_2": "FAIR HAVEN COMMUNITY HEALTH CENTER ATTN: HR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "address_2": "FAIR HAVEN COMMUNITY HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECEW",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "98866",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008042107",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Malatesta LCSW Ladc LLC
• Deborah Pan MD LLC
• Daniel Decarlo III, PHARM.D
• Megan Decarvalho, LCSW
• Stephanie Marie Decesare, PA-C
• Janice Decho, PA-C
• Dominique Decilla, LCSW
• Hannah Babbitt Deck, APRN
• Christopher Paul Decker, APRN
• Korynne Joy Decloux, MD

• Family Nurse Practitioner in New Haven, CT
• Providers in New Haven, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.