Demetra Venancio, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5815 Issued in CT

Practice address

1055 Post Rd
Fairfield, CT 06824-6019

Phone

(203) 259-3440

NPI assigned

Aug 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, CT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Vincents Urgent Care LLCGroup PAC ID 6901119767, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: demetra.venancio@xdr.hhchealthdirect.org

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.

• St. Vincents Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fairfield, CT
  • NPI 1912305483
  Medicare reassignment Care Compare group NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Brookline, MA
  • NPI 1720486830
  Medicare reassignment NPD
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Medicare reassignment
• St. Vincents Urgent Care LLC

  • Internal Medicine Physician
  • Trumbull, CT
  • NPI 1043852569
  NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1609387695
  NPD

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1891275731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246019",
            "telephone_number": "203-259-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Westwind Dr",
            "address_purpose": "LOCATION",
            "city": "Dennis",
            "state": "MA",
            "postal_code": "026382319",
            "country_code": "US",
            "telephone_number": "508-404-4775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Westwind Dr",
            "address_purpose": "LOCATION",
            "city": "Dennis",
            "state": "MA",
            "postal_code": "026382319",
            "country_code": "US",
            "telephone_number": "508-404-4775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Centre St",
            "address_purpose": "LOCATION",
            "city": "Jamaica Plain",
            "state": "MA",
            "postal_code": "02130",
            "country_code": "US",
            "telephone_number": "617-983-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENANCIO",
        "first_name": "DEMETRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6723",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jo Puglisi Vasquez, PH.D.
• Victor G Vaughan, PT
• Jack Vayner, DDS
• Irena Veksler-Offengenden, M.D.
• Luis Angel Velez, P.T.A.
• Andrew Venditti
• Victor L. Pittman, -LMFT,LLC (Shoreline Counseling)
• Winnie M Victor
• Victoria Blank MD PC
• Rebecca Mary Vignogna, DMD

• Medical Physician Assistant in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.