Individual provider Active NPI

Roxana Guadalupe Llovet, MD

  • Psychiatry Physician
  • Bridgeport, CT
National Provider Identifier
1639250087
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036065 Issued in CT
Practice address
1635 Central Avenue
Southwest Connecticut Mental Health System
Bridgeport, CT 06610
Phone
(203) 551-7660
Fax
(203) 551-7481
NPI assigned
Oct 18, 2006
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
Psychiatry Physician 2084P0800X 036065 CT Primary

Addresses

Primary practice location

1635 Central Avenue
Southwest Connecticut Mental Health System
Bridgeport, CT 06610

Mailing address

1635 Central Avenue Room 213
Southwest CT Mental Health System Attn Sandra Grazynski
Bridgeport, CT 06610
Phone (203) 551-7660

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117001351 CT Practitioner - Psychiatry 3678769569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

1635 Central Ave
Bridgeport, CT 06610-2717
Phone (203) 551-7464

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036065CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 2, 2001 Accepting new patients
State of Connecticut CurrentSince Jan 2, 2001 Accepting new patients
The Charlotte Hungerford Hospital Past Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

1635 Central Ave
Rm 213
Bridgeport, CT 06610
Phone (203) 551-7660

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639250087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE ROOM 213",
            "address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA GRAZYNSKI",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "SOUTHWEST CONNECTICUT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLOVET",
        "first_name": "ROXANA",
        "middle_name": "GUADALUPE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "036065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.