Individual provider Active NPI

Carissa Ann Corraro, APRN

  • Nurse Practitioner
  • Southbury, CT
National Provider Identifier
1992549471
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12.013357 Issued in CT
Practice address
900 Main St S Ste 100
Southbury, CT 06488-4213
Phone
(203) 954-9054
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12.013357 CT Primary

Addresses

Primary practice location

900 Main St S Ste 100
Southbury, CT 06488-4213

Mailing address

28 N Benham Rd
Seymour, CT 06483-2247
Phone (203) 954-9054

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
I20240716000395 CT Practitioner - Nurse Practitioner 0446795306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians

Practice addresses (Care Compare)

900 Main St S
Suite 100
Southbury, CT 06488-4213
Phone (860) 650-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.013357CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Associates, LLC Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients
WRK Ventures, LLC PastSince Jun 23, 2024 Accepting new patients

Locations

900 Main St S
Ste 100
Southbury, CT 06488
Phone (203) 262-1911

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1992549471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 N BENHAM RD",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064832247",
            "telephone_number": "203-954-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST S STE 100",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884213",
            "telephone_number": "203-954-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRARO",
        "first_name": "CARISSA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "12.013357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.