Individual provider Active NPI

Tunisia Iris Wynn-Melendez, APRN

  • Gerontology Nurse Practitioner
  • New London, CT
National Provider Identifier
1932913142
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
12.014450 Issued in CT
Practice address
194 Howard St
New London, CT 06320-5544
Phone
(860) 439-0808
NPI assigned
Feb 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 12.014450 CT Primary

Addresses

Primary practice location

194 Howard St
New London, CT 06320-5544

Mailing address

189 Mile Creek Rd
Old Lyme, CT 06371-1719
Phone (860) 961-0553

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
I20260316003950 CT Practitioner - Nurse Practitioner 9638652837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

50 Division St
New Haven, CT 06511-1936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.014450CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Feb 5, 2026 Accepting new patients
Yale University CurrentSince Feb 5, 2026 Accepting new patients

Locations

194 Howard St
New London, CT 06320
Phone (860) 442-0564

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": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1932913142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 MILE CREEK RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711719",
            "telephone_number": "860-961-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-439-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN-MELENDEZ",
        "first_name": "TUNISIA",
        "middle_name": "IRIS",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12.014450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.