Lissy Davis Poulose, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

003902 Issued in CT

Practice address

324 Elm St
Ste 202B
Monroe, CT 06468-2284

Phone

(203) 880-5335

Fax

(203) 907-1234

NPI assigned

Oct 22, 2008

Last updated

Jan 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• HDC Care Solutions, LLC

  • Nurse Practitioner
  • Framingham, MA
  • NPI 1033861349

  Adult Health, CT

  Medicare reassignment Care Compare group NPD
• Careconnectmd Connecticut PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Stamford, CT
  • NPI 1467187336
  Medicare reassignment NPD
• Healthdrive Medical Services Southeast LLC

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1437930146

  Adult Health, CT

  Medicare reassignment NPD
• Value Based Long Term Care H PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Framingham, MA
  • NPI 1134951676

  CT

  Medicare reassignment NPD
• Absolute Outcomes, LLC

  • Internal Medicine Physician
  • Monroe, CT
  • NPI 1073746202
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1790937670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 ELM ST",
            "address_2": "STE 202B",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682284",
            "telephone_number": "203-880-5335",
            "fax_number": "203-907-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ELM ST",
            "address_2": "STE 202B",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682284",
            "telephone_number": "203-880-5335",
            "fax_number": "203-907-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Church St Fl 19",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102100",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULOSE",
        "first_name": "LISSY",
        "middle_name": "DAVIS",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "003902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pivotal Thinking
• Ashlee Plourde
• Christopher Douglas Plude, PHARM D
• Alexandra Pogany
• Constantin Razvan Popescu, NP
• Practitioner Support Services LLP
• Jennifer Crowley Prat, LPCA
• Premier Oral Surgery and Implantology Center LLC
• Primary Health of Connecticut PLLC (Primary Health CT)
• Qi Acupuncture & Chiropractic LLC

• Adult Health Nurse Practitioner in Monroe, CT
• Providers in Monroe, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.