MICHAEL CARUSILLO BA,AS, NPI 1548630213 — WATERBURY (CT)

NPI 1548630213

4+ Years Experience Individual

MICHAEL CARUSILLO BA,AS

10.06.2015
PROVIDER ENUMERATION DATE
10.06.2015
LAST UPDATE DATE
1548630213
NPI NUMBER

About MICHAEL CARUSILLO

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MICHAEL CARUSILLO is a provider established in WATERBURY, CT. The NPI number of MICHAEL CARUSILLO is 1548630213 and was assigned on 10.06.2015. The practitioners primary taxonomy code is: 172V00000X .

Mailing address

  • City: WATERBURY
  • State: CT
  • Postal code: 67022310
  • Phone: 2035749000
  • Fax: 2035749006
  • Address: 141 E MAIN ST
  • Address 2: 4TH FLOOR ADMINISTRATION

Primary Practice Address

  • Region : WATERBURY, CT
  • NPI : 1548630213
  • Phone : 2035971935
  • Fax : 2935978811
  • Postalcode : 67053415
  • Address : 160 MIDLAND RD PALADIN HOUSE

Provider taxonomy - Community Health Worker

  • Taxonomy code: 172V00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.

Contacts:

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  • MICHAEL CARUSILLO BA,AS
  • Address : 160 MIDLAND RD PALADIN HOUSE
  • Region : WATERBURY, CT
  • NPI : 1548630213
  • Phone : 2035971935
  • Fax : 2935978811
  • Postalcode : 67053415

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address160 MIDLAND RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressPALADIN HOUSE
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameWATERBURY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCT
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code67053415
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2035971935
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2935978811
The fax number associated with the location address of the provider being identified.
NPI1548630213
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1172V00000X
Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.
Provider Enumeration Date10.06.2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10.06.2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MICHAEL CARUSILLO
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address141 E MAIN ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address4TH FLOOR ADMINISTRATION
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameWATERBURY
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCT
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code67022310
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2035749000
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2035749006
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1172V00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Community Health Worker
Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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