Individual provider Active NPI

Caroline Londa Arevalo

  • Medical Physician Assistant
  • Bridgeport, CT
National Provider Identifier
1649015579
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
471 Barnum Ave
Bridgeport, CT 06608-2409
Phone
(203) 333-3030
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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 Primary

Addresses

Primary practice location

471 Barnum Ave
Bridgeport, CT 06608-2409

Mailing address

24 Adams Ave Apt 5
Stamford, CT 06902-3732
Phone (203) 615-8354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240905001618 NY Practitioner - Physician Assistant 1658811682 Reassigns benefits to 1 organization
I20260603002187 CT Practitioner - Physician Assistant 1658811682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians
Open Door Family Medical Center IncGroup PAC ID 7113835380, 61 clinicians

Practice addresses (Care Compare)

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 576-3885

5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 632-2737

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center Inc CurrentSince Sep 16, 2024 Accepting new patients
Open Door Family Medical Center, Inc. Past Accepting new patients

Locations

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

2 Church St
Ossining, NY 10562
Phone (914) 502-1415

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1649015579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ADAMS AVE APT 5",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023732",
            "telephone_number": "203-615-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-333-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDA AREVALO",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.