Individual provider Active NPI

Larissa Camano-Selca, RN, BSN, FNP-BC

  • Family Nurse Practitioner
  • Danbury, CT
National Provider Identifier
1700128659
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005307 Issued in CT
Practice address
1202 Eaton CT
Danbury, CT 06811-4052
Phone
(203) 917-9272
NPI assigned
Mar 19, 2013
Last updated
Nov 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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 005307 CT Primary

Addresses

Primary practice location

1202 Eaton CT
Danbury, CT 06811-4052

Mailing address

1202 Eaton CT
Danbury, CT 06811-4052
Phone (203) 917-9272

Other names 1

  • Larissa Camano Former name

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
I20130819000482 CT Practitioner - Nurse Practitioner 7810139003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

19 Grand St
Middletown, CT 06457-2705

41 New St
Danbury, CT 06810-6512
Phone (203) 796-1661

675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Jan 1, 2015 Accepting new patients
Community Health Center Inc CurrentSince Jan 1, 2015 Accepting new patients

Locations

575 Main St
Ste 2
Middletown, CT 06457

Interoperability endpoints

  • Direct secure messaging: larissa.camanoselca@chcict.eclinicaldirectplus.com

Organizations & group practices 2

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.

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1700128659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 EATON CT",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114052",
            "telephone_number": "203-917-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 EATON CT",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114052",
            "telephone_number": "203-917-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMANO-SELCA",
        "first_name": "LARISSA",
        "credential": "RN, BSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "CAMANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.