Individual provider Active NPI

Vivian Izuka Okam, NP

  • Family Nurse Practitioner
  • Milford, CT
National Provider Identifier
1699474494
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11667 Issued in CT
Practice address
46 Soundview Ave
Milford, CT 06460-7877
Phone
(203) 895-4360
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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 11667 CT Primary

Addresses

Primary practice location

46 Soundview Ave
Milford, CT 06460-7877

Mailing address

61 Tanglewood Dr
Hamden, CT 06518-2749
Phone (203) 606-4621

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
I20230501000159 CT Practitioner - Nurse Practitioner 0749645505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Health Care Management LLCGroup PAC ID 8022497874, 38 clinicians

Practice addresses (Care Compare)

4 Hazel Ave
Naugatuck, CT 06770-4706
Phone (203) 723-1456

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as group
Quality
93.23
Improvement activities
40
Cost
61.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Health Care Management,LLC Family CurrentSince Apr 1, 2023 Accepting new patients

Locations

845 Paddock Ave
Meriden, CT 06450
Phone (203) 238-2645

4 Hazel Ave
Naugatuck, CT 06770
Phone (203) 720-3411

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1699474494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 TANGLEWOOD DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182749",
            "telephone_number": "203-606-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SOUNDVIEW AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064607877",
            "telephone_number": "203-895-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAM",
        "first_name": "VIVIAN",
        "middle_name": "IZUKA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.