Individual provider Active NPI

Tamanna Rahman, APRN, CPRP

  • Psychiatric/Mental Health Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1790067395
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6582 Issued in CT
Practice address
270 Congress Ave
New Haven, CT 06519
Phone
(203) 764-9995
NPI assigned
Sep 9, 2011
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6582 CT Primary
Registered Nurse 163W00000X 122042 CT

Addresses

Primary practice location

270 Congress Ave
New Haven, CT 06519

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other practice location 1

141 E Main St
Waterbury Clinical Services
Waterbury, CT 06702-2310
Phone (203) 575-0466

Other identifiers 16

IdentifierTypeStateIssuer
4887750OtherCTCERTIFIED PSYCHIATRIC REHABILITIATION PRACTITIONER
PENDINGOtherCTMHN/TRICARENORTH
D339123 WATERBURYOtherCTBEACON HEALTH STRATEGIES
PENDINGOtherCTMANAGED HEALTH NETWORK/MHN
PENDINGMedicaidCT
060669107OtherCTHEALTHYCT WELLMORE GRP/FACILITY
PMHNP-BC 2016011186OtherCTCOMMISSION ON CERTIFICATION ANCC-PSYCHIATRIC MENTAL HEALTH NURSE PRACCTIITIONER
060669107OtherCTCONNECTICARE/UBH WELLMORE GRP/FACILITY
060669107OtherCTLIBERTY/OXFORD FREEDOM PLANS/UBH WELLMORE GRP/FACILITY
PENDINGOtherCTAETNA BEHAVIORAL HEALTH
060669107OtherCTUNITED HEALTHCARE/UBH WELLMORE GRP/FACILITY
CSP.0063703OtherCTCONTROLLED SUBSTANCE REGISTRATION FOR PRACTICIONER
060669107OtherCTOPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
060669107OtherCTANTHEM BEHAVIORAL HEALTH GRP/FACILITY
13872963OtherCTCAQH
PENDINGOtherCTCIGNA BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122042CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Dec 23, 2017 Accepting new patients
Yale University CurrentSince Dec 23, 2017 Accepting new patients

Locations

270 Congress Ave
New Haven, CT 06519
Phone (203) 584-7387

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1790067395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CONGRESS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-764-9995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 E Main St",
            "address_2": "Waterbury Clinical Services",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067022310",
            "country_code": "US",
            "telephone_number": "203-575-0466",
            "fax_number": "203-575-1837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "TAMANNA",
        "credential": "APRN, CPRP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "6582",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "122042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED PSYCHIATRIC REHABILITIATION PRACTITIONER",
            "identifier": "4887750",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN/TRICARENORTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "D339123 WATERBURY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK/MHN",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT              WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON CERTIFICATION ANCC-PSYCHIATRIC MENTAL HEALTH NURSE PRACCTIITIONER",
            "identifier": "PMHNP-BC 2016011186",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE/UBH      WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIBERTY/OXFORD FREEDOM PLANS/UBH    WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE/UBH    WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE REGISTRATION FOR PRACTICIONER",
            "identifier": "CSP.0063703",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM BEHAVIORAL HEALTH/UBH  WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BEHAVIORAL HEALTH GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13872963",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.