Michael Corjulo, C.P.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

002019 Issued in CT

Practice address

299 Washington Ave Ste LL
Hamden, CT 06518-3039

Phone

(203) 288-4288

Fax

(203) 288-1566

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michael.corjulo.1@7895.direct.athenahealth.com

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.

• Children'S Medical Group, LLC

  • Pediatrics Physician
  • Hamden, CT
  • NPI 1588603997
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1790796647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 WASHINGTON AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183026",
            "telephone_number": "203-288-4288",
            "fax_number": "203-288-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 WASHINGTON AVE STE LL",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183039",
            "telephone_number": "203-288-4288",
            "fax_number": "203-288-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORJULO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004241931",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.corjulo.1@7895.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "299 Washington Ave Ste Ll",
            "city": "Hamden",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065183039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shenita Trivette Cooper, LMT
• Todd Cooperman, PHARMD, RPH
• Nicola Shamsey Corbett, MD
• Ricardo F Cordido, MD
• Amber Corey
• Cornerstone Counseling Services LLC
• Nancy Christina Corvigno, MSPT
• Kimberly Cosgrove
• Mark Cottle
• Andrea Coughlin

• Pediatric Nurse Practitioner in Hamden, CT
• Providers in Hamden, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.