Individual provider Active NPI

Blanca L. Paccha, FNP-C, MPH

  • Family Nurse Practitioner
  • West Haven, CT
National Provider Identifier
1790279172
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7678 Issued in CT
Practice address
950 Campbell Ave BLDG 2B
West Haven, CT 06516
Phone
(203) 932-5711
Fax
(203) 937-4808
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 7678 CT Primary

Addresses

Primary practice location

950 Campbell Ave BLDG 2B
West Haven, CT 06516

Mailing address

400 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3174

Other practice location 1

675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971

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
I20190918003347 CT Practitioner - Nurse Practitioner 1153651047 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Haven Community Health Clinic, Inc CurrentSince Nov 24, 2024 Accepting new patients
Fair Haven Community Health Clinic Inc CurrentSince Nov 24, 2024 Accepting new patients

Locations

374 Grand Ave
New Haven, CT 06513
Phone (203) 752-5203

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1790279172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE BLDG 2B",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-932-5711",
            "fax_number": "203-937-4808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Main St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064572732",
            "country_code": "US",
            "telephone_number": "860-347-6971",
            "fax_number": "860-343-7379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACCHA",
        "first_name": "BLANCA",
        "middle_name": "L.",
        "credential": "FNP-C, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.