Individual provider Active NPI

Christabel Ansah, APRN FNP-BC

  • Family Nurse Practitioner
  • Glastonbury, CT
National Provider Identifier
1710630801
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11116 Issued in CT
Practice address
2639 Main St
Glastonbury, CT 06033-2023
Phone
(860) 659-1329
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11116 CT
Family Nurse Practitioner 363LF0000X 11116 CT Primary

Addresses

Primary practice location

2639 Main St
Glastonbury, CT 06033-2023

Mailing address

2639 Main St
Glastonbury, CT 06033-2023
Phone (860) 659-1329

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
I20230222000419 CT Practitioner - Nurse Practitioner 3870966872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Health Care Management,LLC Family CurrentSince Sep 18, 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

1253 Hartford Tpke
Vernon Rockville, CT 06066
Phone (860) 375-7315

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.

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1710630801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332023",
            "telephone_number": "860-659-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332023",
            "telephone_number": "860-659-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSAH",
        "first_name": "CHRISTABEL",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "11116",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.