Individual provider Active NPI

Cassandra Waterbury, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1760357099
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12.015435 Issued in CT
Practice address
21 Montauk Ave
New London, CT 06320-4906
Phone
(860) 975-7277
NPI assigned
Oct 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 12.015435 CT Primary

Addresses

Primary practice location

21 Montauk Ave
New London, CT 06320-4906

Mailing address

33 Plains Rd
Haddam, CT 06438-1232
Phone (860) 975-7277

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
I20251218003196 CT Practitioner - Nurse Practitioner 9335634195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Community Services IncGroup PAC ID 7517981517, 8 clinicians

Practice addresses (Care Compare)

21 Montauk Ave
New London, CT 06320-4906
Phone (860) 439-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.015435CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Community Services, Inc. CurrentSince Dec 9, 2025 Accepting new patients
Urologic Associates, PC PastSince Dec 9, 2025 Accepting new patients

Locations

21 Montauk Ave
New London, CT 06320
Phone (860) 439-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1760357099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PLAINS RD",
            "city": "HADDAM",
            "state": "CT",
            "postal_code": "064381232",
            "telephone_number": "860-975-7277"
        },
        {
            "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": "860-975-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERBURY",
        "first_name": "CASSANDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.015435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.