Individual provider Active NPI

Lissette Rivas Siracusa, APRN

  • Family Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1750804316
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7088 Issued in CT
Practice address
49 Day St
Norwalk, CT 06854-4901
Phone
(203) 854-9292
Fax
(203) 854-9437
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 7088 CT Primary

Addresses

Primary practice location

49 Day St
Norwalk, CT 06854-4901

Mailing address

49 Day St
Norwalk, CT 06854-4901
Phone (203) 854-9292

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
I20240424000225 CT Practitioner - Nurse Practitioner 1658610746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Associates of Danbury, PCGroup PAC ID 3971494782, 13 clinicians

Practice addresses (Care Compare)

51 -53 Kenosia Ave
Danbury, CT 06810-2304
Phone (203) 748-0330

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7088CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of Danbury PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

51-53 Kenosia Ave
Danbury, CT 06810
Phone (203) 748-0330

73 Sand Pit Rd
Ste 204
Danbury, CT 06810
Phone (203) 212-8000

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 and National Provider Directory roles.

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750804316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 DAY ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068544901",
            "telephone_number": "203-854-9292",
            "fax_number": "203-854-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 DAY ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068544901",
            "telephone_number": "203-854-9292",
            "fax_number": "203-854-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS SIRACUSA",
        "first_name": "LISSETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.