Individual provider Active NPI

Roseanna Petonito

  • Family Nurse Practitioner
  • Branford, CT
National Provider Identifier
1679128102
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8352 Issued in CT
Practice address
251 W Main St Ste 5C
Branford, CT 06405-4047
Phone
(203) 481-0077
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 8352 CT Primary

Addresses

Primary practice location

251 W Main St Ste 5C
Branford, CT 06405-4047

Mailing address

251 W Main St Ste 5C
Branford, CT 06405-4047

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
I20191003002542 CT Practitioner - Nurse Practitioner 2668703786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a. Perrotti,M.D.LLC CurrentSince Oct 24, 2019 Accepting new patients
Yale University CurrentSince Feb 11, 2022 Accepting new patients
Yale University CurrentSince Feb 11, 2022 Accepting new patients

Locations

251 W Main St
Branford, CT 06405
Phone (203) 315-5300

251 W Main St
Ste 5
Branford, CT 06405
Phone (203) 481-0077

251 W Main St
Ste 5C
Branford, CT 06405
Phone (203) 481-0077

111 Goose Ln
Guilford, CT 06437
Phone (203) 453-7100

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: rpetonito553844@direct.ynhh.org

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 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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1679128102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 W MAIN ST STE 5C",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 W MAIN ST STE 5C",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054047",
            "telephone_number": "203-481-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETONITO",
        "first_name": "ROSEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.