Individual provider Active NPI

Elissa Reyes, MSN CCRN ACNPC- AG

  • Acute Care Nurse Practitioner
  • Stratford, CT
National Provider Identifier
1912884305
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
15037 Issued in CT
Practice address
402 Franklin Ave
Stratford, CT 06614-4636
Phone
(203) 727-8030
NPI assigned
Aug 19, 2025
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 15037 CT Primary

Addresses

Primary practice location

402 Franklin Ave
Stratford, CT 06614-4636

Mailing address

402 Franklin Ave
Stratford, CT 06614-4636
Phone (203) 727-8030

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
I20260505003458 CT Practitioner - Nurse Practitioner 3173091477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

35 Park St
New Haven, CT 06519-1110
Phone (203) 785-4191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15037CTMDAcute Care Nurse Practitioner

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1912884305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 FRANKLIN AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144636",
            "telephone_number": "203-727-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 FRANKLIN AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144636",
            "telephone_number": "203-727-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ELISSA",
        "credential": "MSN CCRN ACNPC- AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "15037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.