| Mr Edin Memisevich, NP | |
|
1 Long Wharf Dr, New Haven, CT 06511-5946 | |
| (203) 781-4600 | |
| (203) 781-4624 |
| Full Name | Mr Edin Memisevich |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 1 Long Wharf Dr, New Haven, Connecticut |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992160105 | NPI | - | NPPES |
| 008056168 | Medicaid | CT | |
| 008063396 | Other | CT | MEMISEVICH MEDICAID |
| 004217099 | Medicaid | CT | |
| 008056033 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 6411 (Connecticut) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | 6411 (Connecticut) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ophelia Medical Group Fl Pa | 7810398534 | 76 |
| Ophelia Medical Group Fl Pa | 7810398534 | 76 |
| Ophelia Medical Group Fl Pa | 7810398534 | 76 |
| Ophelia Medical Group Fl Pa | 7810398534 | 76 |
| First Choice Health Centers Inc | 2769417609 | 34 |
| Entity Name | First Choice Health Centers Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215923131 PECOS PAC ID: 2769417609 Enrollment ID: O20060127000447 |
| Entity Name | Ophelia Medical Group Fl Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588244750 PECOS PAC ID: 7810398534 Enrollment ID: O20211101002482 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Edin Memisevich, NP 1 Long Wharf Dr, New Haven, CT 06511-5946 Ph: (203) 781-4600 | Mr Edin Memisevich, NP 1 Long Wharf Dr, New Haven, CT 06511-5946 Ph: (203) 781-4600 |
Audrey P Senior, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-5860 Fax: 203-688-7533 | |
Ashley Antonucci, DNP- FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Long Wharf Dr, New Haven, CT 06511 Phone: 203-688-8800 | |
Bailey Daum, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 40 Trumbull St, New Haven, CT 06510 Phone: 646-270-4857 | |
Kentrone Vines, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-4242 | |
Mrs. Lisa Jane Warren, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-7952 | |
Mrs. Rocca L Perruccio, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 428 Columbus Ave, New Haven, CT 06519 Phone: 203-503-3000 Fax: 203-503-3224 | |
Alexa Blood, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 Howard Ave, New Haven, CT 06519 Phone: 203-785-2565 |