Individual provider Active NPI

Linda Grisgraber, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • East Haven, CT
National Provider Identifier
1922051135
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
001868 Issued in CT
Practice address
310 Main St
Lowr Level
East Haven, CT 06512-2919
Phone
(203) 556-5225
Fax
(203) 494-7126
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 001868 CT Primary

Addresses

Primary practice location

310 Main St
Lowr Level
East Haven, CT 06512-2919

Mailing address

310 Main St
Lowr Level
East Haven, CT 06512-2919
Phone (203) 556-5225

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
I20040728000469 CT Practitioner - Certified Clinical Nurse Specialist (CNS) 3274503206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Bridgeport Ave
Suite 307
Shelton, CT 06484-4669
Phone (203) 216-7268

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1868CTMDSocial Worker
001868CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Medoptions Behavioral Health Assoc, LLC Past Accepting new patients
Bridges Healthcare Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bridgesct/r4/

Organizations & group practices 3

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1922051135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "address_2": "LOWR LEVEL",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-556-5225",
            "fax_number": "203-494-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "address_2": "LOWR LEVEL",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-556-5225",
            "fax_number": "203-494-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISGRABER",
        "first_name": "LINDA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "001868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

Verify at the official NPI Registry.