Individual provider Active NPI

Erwin Nepomuceno, APRN

  • Family Nurse Practitioner
  • Hamden, CT
National Provider Identifier
1700504909
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10886 Issued in CT
Practice address
1952 Whitney Ave Ste 14
Hamden, CT 06517-1209
Phone
(203) 776-4444
NPI assigned
Aug 15, 2022
Last updated
Nov 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10886 CT Primary
Registered Nurse 163W00000X 113117 CT

Addresses

Primary practice location

1952 Whitney Ave Ste 14
Hamden, CT 06517-1209

Mailing address

8 Roberta Dr
Middletown, CT 06457-5510
Phone (860) 759-4792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113117CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Assoc of CT LLC CurrentSince Dec 11, 2023 Accepting new patients

Locations

1952 Whitney Ave
Ste 14
Hamden, CT 06517
Phone (203) 776-4444

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700265600000",
    "number": "1700504909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ROBERTA DR",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575510",
            "telephone_number": "860-759-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 WHITNEY AVE STE 14",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171209",
            "telephone_number": "203-776-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEPOMUCENO",
        "first_name": "ERWIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10886",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "113117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.