Individual provider Active NPI

Quiona Cerisse Brooks, NP

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1629792593
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11033 Issued in CT
Practice address
136 Sherman Ave
New Haven, CT 06511-5238
Phone
(203) 745-5660
NPI assigned
Oct 3, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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 11033 CT Primary

Addresses

Primary practice location

136 Sherman Ave
New Haven, CT 06511-5238

Mailing address

136 Sherman Ave
New Haven, CT 06511-5238

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
I20231005000702 CT Practitioner - Nurse Practitioner 8921453382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11033CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
It Takes a Village Care LLC Family Current Accepting new patients
Community Health and Wellness Center of Greater Torrington Inc CurrentSince Sep 13, 2023 Accepting new patients
Community Health and Wellness Center of Greater Torrington Inc CurrentSince Sep 13, 2023 Accepting new patients
Destination Psychiatry, PLLC Past Accepting new patients

Locations

469 Migeon Ave
Torrington, CT 06790
Phone (860) 387-0439

10 Center St
Winsted, CT 06098
Phone (860) 238-4211

Organizations & group practices 4

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1629792593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238",
            "telephone_number": "203-745-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "QUIONA",
        "middle_name": "CERISSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.