Individual provider Active NPI

Sandra A Mesquita

  • Licensed Practical Nurse
  • New Haven, CT
National Provider Identifier
1912177221
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
028618 Issued in CT
Practice address
226 Dixwell Ave
New Haven, CT 06511-3456
Phone
(203) 503-3420
NPI assigned
Mar 4, 2008
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 028618 CT Primary

Addresses

Primary practice location

226 Dixwell Ave
New Haven, CT 06511-3456

Mailing address

294 Howard Ave
New Haven, CT 06519-2626
Phone (203) 772-2253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
028618CTMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1912177221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065192626",
            "telephone_number": "203-772-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 DIXWELL AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113456",
            "telephone_number": "203-503-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESQUITA",
        "first_name": "SANDRA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "028618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.