Individual provider Active NPI

Carolyn Umengan Rojo, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
National Provider Identifier
1669745824
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004838 Issued in CT
Practice address
22 Masonic Avenue
Wallingford, CT 06492
Phone
(203) 679-5900
NPI assigned
Feb 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 004838 CT Primary

Addresses

Primary practice location

22 Masonic Avenue
Wallingford, CT 06492

Mailing address

22 Masonic Avenue
Wallingford, CT 06492
Phone (203) 679-5900

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
I20120423000045 CT Practitioner - Nurse Practitioner 8224299052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

4 A Devine St
North Haven, CT 06473-2142
Phone (203) 288-9650

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004838CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Masonicare Behavioral Health, LLC CurrentSince May 1, 2015 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Jun 10, 2018 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients
Branford Internal Medicine LLC PastSince May 15, 2000 Accepting new patients

Locations

500 E Main St
Ste 212
Branford, CT 06405
Phone (203) 481-5665

322 E Main St
Ste 1B
Branford, CT 06405
Phone (203) 488-7228

4 Devine St
#A
North Haven, CT 06473
Phone (203) 287-6900

240 Indian River Rd
Ste A5
Orange, CT 06477
Phone (203) 799-1252

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

67 Masonic Ave
Fl 1
Wallingford, CT 06492
Phone (203) 265-0355

Interoperability endpoints

  • Direct secure messaging: crojo324482@direct.ynhh.org

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.

Hospital & facility affiliations 4

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": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1669745824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVENUE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-679-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVENUE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-679-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJO",
        "first_name": "CAROLYN",
        "middle_name": "UMENGAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.