Individual provider Active NPI

Eugenia Ann Corriero, PA-C

  • Medical Physician Assistant
  • Brookfield, CT
National Provider Identifier
1639216427
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001466 Issued in CT
Practice address
300 Federal Rd
Building 1, Suite 108
Brookfield, CT 06804-2412
Phone
(203) 740-7500
NPI assigned
Jan 31, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001466 CT Primary

Addresses

Primary practice location

300 Federal Rd
Building 1, Suite 108
Brookfield, CT 06804-2412

Mailing address

13 Robins LN
Brookfield, CT 06804-1106
Phone (203) 775-5420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1466CTMDAddiction (Substance Use Disorder) Counselor
001466CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookfield Preventive Medicine, LLC Medical PastSince Jun 1, 2005 Accepting new patients
CT Colony Emergency Physicians, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ecorriero@direct.wtbyhosp.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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639216427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ROBINS LN",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041106",
            "telephone_number": "203-775-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FEDERAL RD",
            "address_2": "BUILDING 1, SUITE 108",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042412",
            "telephone_number": "203-740-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRIERO",
        "first_name": "EUGENIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.