Individual provider Active NPI

Luis Vera, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1649632670
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12108 Issued in CT
Practice address
47 Town St
Norwich, CT 06360-2323
Phone
(860) 892-7042
NPI assigned
Mar 29, 2016
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12108 CT Primary

Addresses

Primary practice location

47 Town St
Norwich, CT 06360-2323

Mailing address

8609 2ND Ave Ste 404B
Silver Spring, MD 20910-3374
Phone (240) 398-3514

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
I20231103000756 CT Practitioner - Nurse Practitioner 5890142418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

47 Town St
Norwich, CT 06360-2323
Phone (860) 892-7042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Community and Family Services, Inc. CurrentSince Sep 11, 2023 Accepting new patients

Locations

70 Main St
Jewett City, CT 06351
Phone (860) 376-7040

47 Town St
Norwich, CT 06360

Interoperability endpoints

  • Direct secure messaging: lvera596774@direct.ochin.org

Organizations & group practices 1

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1649632670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 2ND AVE STE 404B",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103374",
            "telephone_number": "240-398-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602323",
            "telephone_number": "860-892-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA",
        "first_name": "LUIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.