Individual provider Active NPI

Robert G Krause, APRN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • New Haven, CT
National Provider Identifier
1811911795
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
002020 Issued in CT
Practice address
285 Nicoll St Ste 104
New Haven, CT 06511-2625
Phone
(203) 606-2395
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 Registered Nurse 163WP0808X E59571 CT
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 002020 CT Primary

Addresses

Primary practice location

285 Nicoll St Ste 104
New Haven, CT 06511-2625

Mailing address

285 Nicoll St Ste 104
New Haven, CT 06511-2625
Phone (203) 606-2395

Other identifiers 1

IdentifierTypeStateIssuer
004246064MedicaidCT

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
I20040607001449 CT Practitioner - Certified Clinical Nurse Specialist (CNS) 4486637972 Reassigns benefits to 1 organization
Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centered PLLCGroup PAC ID 7810368594, 3 clinicians

Practice addresses (Care Compare)

285 Nicoll St
Suite 104
New Haven, CT 06511-0925
Phone (203) 606-2395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
E59571CTMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole R. Kerr, LLC Past Accepting new patients
Revive Wellness Center, LLC Past Accepting new patients
Baystate Medical Practices, Inc PastSince Apr 28, 2024 Accepting new patients
State of Connecticut Past Accepting new patients

Organizations & group practices 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1811911795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 NICOLL ST STE 104",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112625",
            "telephone_number": "203-606-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 NICOLL ST STE 104",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112625",
            "telephone_number": "203-606-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "E59571",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CT",
            "license": "002020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004246064",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.