Individual provider Active NPI

Rose Marie Zmyslinski, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1750460770
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
000872 Issued in CT
Practice address
21 Montauk Ave
New London, CT 06320-4906
Phone
(860) 439-6400
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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 000872 CT Primary

Addresses

Primary practice location

21 Montauk Ave
New London, CT 06320-4906

Mailing address

21 Montauk Ave
New London, CT 06320-4906
Phone (860) 271-4783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111128000168 CT Practitioner - Nurse Practitioner 4385818533 Reassigns benefits to 2 organizations
I20210602001579 RI Practitioner - Nurse Practitioner 4385818533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians
Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

118 S Broad St
Pawcatuck, CT 06379-1925
Phone (860) 572-8834

22 Case St
Norwich, CT 06360-2215
Phone (860) 823-1399

41 Faire Harbour PL
New London, CT 06320-4710
Phone (860) 437-6914

4705 Old Post Rd
Unit a
Charlestown, RI 02813-1842
Phone (401) 364-7705

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
William W Backus Hospital CurrentSince Dec 1, 1994 Accepting new patients
Connecticut Behavioral Health Assoc, P.C. Psychiatric/Mental Health CurrentSince Apr 1, 2014 Accepting new patients
Gateway Healthcare Inc CurrentSince Jun 21, 2021 Accepting new patients
The William W Backus Hospital Current Accepting new patients
Urologic Associates, PC PastSince May 6, 2019 Accepting new patients

Locations

616 Gold Star Hwy
Groton, CT 06340
Phone (860) 449-0020

70 Main St
Jewett City, CT 06351
Phone (860) 376-7040

41 Faire Harbour Pl
New London, CT 06320
Phone (860) 437-6914

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

118 S Broad St
Pawcatuck, CT 06379
Phone (860) 572-8834

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1 Virginia Ave
Ste 200
Providence, RI 02905

Interoperability endpoints

  • Direct secure messaging: rose.zmyslinski.1@32885.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1750460770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-271-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-439-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZMYSLINSKI",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "000872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.