Individual provider Active NPI

Joan Telemaque, MA, MSN, RN,PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1619447935
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7989 Issued in CT
Practice address
16 Robinson St
New London, CT 06320-5425
Phone
(860) 235-8352
NPI assigned
Nov 29, 2018
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7989 CT Primary

Addresses

Primary practice location

16 Robinson St
New London, CT 06320-5425

Mailing address

16 Robinson St
New London, CT 06320-5425
Phone (860) 235-8352

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
I20190617002020 CT Practitioner - Nurse Practitioner 9234462649 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science - Nursing, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince May 1, 2019 Accepting new patients
Tuning Belle Mental Health Services CurrentSince Sep 25, 2022 Accepting new patients
State of Connecticut CurrentSince May 1, 2019 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

Interoperability endpoints

  • Direct secure messaging: joan.telemaque.p1@direct.wheelerclinic.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1619447935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ROBINSON ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205425",
            "telephone_number": "860-235-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ROBINSON ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205425",
            "telephone_number": "860-235-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELEMAQUE",
        "first_name": "JOAN",
        "credential": "MA, MSN, RN,PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "7989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.