Individual provider Active NPI

Elysia Marie Cerreta-Dial, AGNP

  • Gerontology Nurse Practitioner
  • Stratford, CT
National Provider Identifier
1639694441
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
7166 Issued in CT
Practice address
2595 Main St
Stratford, CT 06615-5855
Phone
(203) 345-0404
Fax
(203) 908-4110
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7166 CT
Gerontology Nurse Practitioner 363LG0600X 7166 CT Primary

Addresses

Primary practice location

2595 Main St
Stratford, CT 06615-5855

Mailing address

2595 Main St
Stratford, CT 06615-5855
Phone (203) 345-0404

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
I20171004000212 CT Practitioner - Nurse Practitioner 7810262771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2595 Main St
Stratford, CT 06615-5855
Phone (203) 345-0404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7166CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Advocates International, Inc. CurrentSince Sep 11, 2018 Accepting new patients
Health Care Advocates International, LLC Past Accepting new patients
Health Care Advocates International, LLC Past Accepting new patients

Locations

2595 Main St
Stratford, CT 06615
Phone (203) 345-0404

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.

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1639694441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155855",
            "telephone_number": "203-345-0404",
            "fax_number": "203-908-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155855",
            "telephone_number": "203-345-0404",
            "fax_number": "203-908-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERRETA-DIAL",
        "first_name": "ELYSIA",
        "middle_name": "MARIE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "7166",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.