Individual provider Active NPI

Carissa Ann Tufano, MSN

  • Nurse Practitioner
  • Avon, CT
National Provider Identifier
1760639819
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
003970 Issued in CT
Practice address
21 Waterville Rd
Harvest Healthcare
Avon, CT 06001-2097
Phone
(860) 678-9755
Fax
(860) 284-6804
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 079510 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003970 CT
Nurse Practitioner 363L00000X 003970 CT Primary

Addresses

Primary practice location

21 Waterville Rd
Harvest Healthcare
Avon, CT 06001-2097

Mailing address

21 Waterville Rd
Harvest Healthcare
Avon, CT 06001-2097
Phone (860) 678-9755

Other identifiers 2

IdentifierTypeStateIssuer
079510OtherCTRN LICENSE
003970OtherCTAPRN LICENSE

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
I20081206000101 CT Practitioner - Nurse Practitioner 1850452087 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
079510CTMDPsychiatric/Mental Health Registered Nurse
003970CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc Psychiatric/Mental Health CurrentSince Jul 17, 2017 Accepting new patients
Harvest Healthcare LLC Nurse Practitioner CurrentSince Dec 21, 2010 Accepting new patients
Step Up Care PC LLC CurrentSince Apr 22, 2019 Accepting new patients
Sunrise Psychological Services LLC CurrentSince Aug 20, 2018 Accepting new patients
Behavioral Wellness Partners, LLC CurrentSince Dec 22, 2020 Accepting new patients
Optimus Health Care Inc CurrentSince Nov 3, 2016 Accepting new patients

Locations

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

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

36 Broadway St
Colchester, CT 06415
Phone (860) 537-4606

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

1165 King St
Greenwich, CT 06831
Phone (203) 531-1335

55 Grand St
New Britain, CT 06052
Phone (845) 459-5767

172 Rocky Rest Rd
Shelton, CT 06484
Phone (203) 924-6268

1351 Washington Blvd
Stamford, CT 06902
Phone (203) 276-7464

494 Elm St
Stamford, CT 06902
Phone (203) 325-0200

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 6

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1760639819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "address_2": "HARVEST HEALTHCARE",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-678-9755",
            "fax_number": "860-284-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "address_2": "HARVEST HEALTHCARE",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-678-9755",
            "fax_number": "860-284-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUFANO",
        "first_name": "CARISSA",
        "middle_name": "ANN",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "079510",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003970",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "003970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "079510",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "003970",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.