Melissa A Fazzolari, APRN - Medicare Nurse Practitioner in Portland, CT

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Melissa A Fazzolari, APRN is a medicare enrolled "Nurse Practitioner - Gerontology" in Portland, Connecticut. Her current practice location is 270 Main St Ste A, Portland, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 358-5040.

Melissa A Fazzolari is licensed to practice in Connecticut (license number 7770) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477041564.

Contact Information

Melissa A Fazzolari, APRN
270 Main St Ste A,
Portland, CT 06480-1836
(860) 358-5040
(860) 358-8658

Map and Direction




Provider's Profile

Full NameMelissa A Fazzolari
GenderFemale
SpecialityNurse Practitioner - Gerontology
Location270 Main St Ste A, Portland, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1477041564
  • Provider Enumeration Date: 04/25/2018
  • Last Update Date: 02/05/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 6901157155
  • Enrollment ID: I20180926003765

Medical Identifiers

Medical identifiers for Melissa A Fazzolari such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477041564NPI-NPPES
008082360MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 7770 (Connecticut)Primary
363L00000XNurse Practitioner 7770 (Connecticut)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Melissa A Fazzolari allows following entities to bill medicare on her behalf.
Entity NameYale University
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093862740
PECOS PAC ID: 9436061736
Enrollment ID: O20031124000690
Entity NameProhealth Physicians Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720194053
PECOS PAC ID: 1355246950
Enrollment ID: O20031205000602
Entity NameNortheast Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043278351
PECOS PAC ID: 1254233836
Enrollment ID: O20040123000522
Entity NamePractitioner Support Services Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114115706
PECOS PAC ID: 3375596984
Enrollment ID: O20050223000656
Entity NameConnecticut Gi Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023124625
PECOS PAC ID: 9830110758
Enrollment ID: O20070112000011

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Melissa A Fazzolari is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Melissa A Fazzolari, APRN
28 Crescent St,
Middletown, CT 06457-3654

Ph: (860) 358-4870		Melissa A Fazzolari, APRN
270 Main St Ste A,
Portland, CT 06480-1836

Ph: (860) 358-5040

Reviews and Comments


Nurse Practitioner Nurses in Portland, CT

Dulijeta Becirovic, RN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 63 Cedar Ter, Portland, CT 06480
Phone: 860-808-8964    
Mrs. Carly M Odesina, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 270 Main St, Portland, CT 06480
Phone: 860-342-3392    Fax: 860-358-8658
Morgan Bryant Feshler,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 270 Main St Ste A, Portland, CT 06480
Phone: 860-358-5040    
Mrs. Wendy Griswold, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 270 Main St, Portland, CT 06480
Phone: 860-342-3392    Fax: 860-358-8658
Miss Gabrielle Elizabeth Schiavone, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 270 Main St Ste A, Portland, CT 06480
Phone: 860-358-5040    Fax: 860-358-8658
Ms. Wendy Ann Tagan Conroy, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 270 Main St, Portland, CT 06480
Phone: 860-342-3392    Fax: 860-358-8658

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.