Individual provider Active NPI

Nezha Elomari, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Avon, CT
National Provider Identifier
1700678844
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
014317 Issued in CT
Practice address
21 Waterville Rd
Avon, CT 06001-2097
Phone
(203) 804-8015
Fax
(475) 219-6512
NPI assigned
May 22, 2025
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 014317 CT Primary

Addresses

Primary practice location

21 Waterville Rd
Avon, CT 06001-2097

Mailing address

21 Waterville Rd
Avon, CT 06001-2097
Phone (203) 804-8015

Other practice location 1

2447 Whitney Ave
Hamden, CT 06518-3211
Phone (203) 804-8015

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
I20250823000055 CT Practitioner - Nurse Practitioner 0840790960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014317CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC CurrentSince Jun 5, 2025 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1700678844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "203-804-8015",
            "fax_number": "475-219-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "203-804-8015",
            "fax_number": "475-219-6512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2447 Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065183211",
            "country_code": "US",
            "telephone_number": "203-804-8015",
            "fax_number": "475-219-6512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELOMARI",
        "first_name": "NEZHA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "014317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.