CMS-1500 Box 24J / 33a • NPI
1841583994
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
130 DIVISION ST, DERBY, CT, 06418-1326
✓ 9-Digit EDI 837 ZIP+4 (06418-1326)
⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT:
NPI
1841583994 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(1) — Conviction of Program-Related Crimes (Mandatory 5-Yr Min) — Effective 2020-06-18). Verify before submitting Medicare/Medicaid claims.
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1841583994 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HEATHER A ALFONSO, MSN APRN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 130 DIVISION ST, DERBY, CT, 06418-1326 |
| Practice Telephone / Fax | Tel: (203) 732-1570 | Fax: (203) 732-1576 |
| Administrative Mailing Address | 130 DIVISION ST, DERBY, CT, 06418-1326 |
| Enumeration & Last Sync | Enumerated: 2011-05-24 | CMS Record Updated: 2015-01-23 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HEATHER A ALFONSO, MSN APRN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
364SA2200X — Clinical Nurse Specialist, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Adult Health | State: CT | License: 004657 | Primary: Secondary |
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: CT | License: 004657 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: CT | License: 004657 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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