Individual provider Active NPI

Kassandra Priscilla August-Marcucio, APRN

  • Acute Care Nurse Practitioner
  • West Haven, CT
National Provider Identifier
1992042915
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5268 Issued in CT
Practice address
950 Campbell Ave
West Haven, CT 06516-2770
Phone
(203) 932-5711
NPI assigned
Jan 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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 5268 CT Primary

Addresses

Primary practice location

950 Campbell Ave
West Haven, CT 06516-2770

Mailing address

22 General Wooster Rd
Derby, CT 06418-2253
Phone (203) 734-8136

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
5268CTMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1992042915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GENERAL WOOSTER RD",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182253",
            "telephone_number": "203-734-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUST-MARCUCIO",
        "first_name": "KASSANDRA",
        "middle_name": "PRISCILLA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "5268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.