Individual provider Active NPI

Melissa Amicone, APRN, FNP

  • Family Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1831474394
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.005362 Issued in CT
Practice address
51 N Elm St
Waterbury, CT 06702-1545
Phone
(203) 574-4000
Fax
(203) 574-4003
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 643800-1 NY
Family Nurse Practitioner 363LF0000X 12.005362 CT Primary

Addresses

Primary practice location

51 N Elm St
Waterbury, CT 06702-1545

Mailing address

51 N Elm St
Waterbury, CT 06702-1545
Phone (203) 574-4000

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
I20140128000355 CT Practitioner - Nurse Practitioner 9638308489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
643800-1NYMDRegistered Nurse
005362CTMDSpeech-Language Pathologist
12.005362CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Community Health Center Inc CurrentSince Apr 1, 2024 Accepting new patients

Locations

51 N Elm St
Waterbury, CT 06702
Phone (203) 574-4000

Interoperability endpoints

  • Direct secure messaging: melissa.amicone@chcict.eclinicaldirectplus.com

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": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1831474394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N ELM ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021545",
            "telephone_number": "203-574-4000",
            "fax_number": "203-574-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N ELM ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021545",
            "telephone_number": "203-574-4000",
            "fax_number": "203-574-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMICONE",
        "first_name": "MELISSA",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "643800-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.005362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.