DAIJSIA MELENA BUBB (APRN) – Family Nurse Practitioner, NPI 1023595725

DAIJSIA MELENA BUBB (APRN) is a healthcare provider. based in New haven, Connecticut. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 9850 (CT). The NPI Number for DAIJSIA MELENA BUBB (APRN) is 1023595725

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
DAIJSIA MELENA BUBB (APRN)
NPI
1023595725
Phone
(203) 777-7411
Address
374 GRAND AVE
Enumeration Date
25 July 2018
Last Update Date
1 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2018 (8 years ago)
PAC ID
9830440247
Group Practice PAC ID
4183511538
Professional Enrollment ID
I20250807002048
Address ID
CT065130000NE374XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Digital endpointsOther names

4,196 NURSE PRACTITIONER in CT

Provider Addresses for DAIJSIA MELENA BUBB (APRN)

  • 374 GRAND AVE

    NEW HAVEN, CT 065133733

    Phone: (203) 777-7411

    Type: Mailing

  • 10, Keenan Road, Brighton, Boston, Suffolk County, Massachusetts, 02135, United States

    BRIGHTON, MA 021352128

    Phone: (617) 319-4305

    Type: Mailing

  • 39, East Avenue, Woodlawn, Pawtucket, Providence County, Rhode Island, 02860, United States

    PAWTUCKET, RI 02860

    Phone: (401) 729-0080

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250807002048INurse PractitionerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06513)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183511538View full group profile
NameSpecialtyState
Clinical Social WorkerCT
-GA
-CT
Nurse PractitionerCT
Family PracticeCT
Family PracticeCT
-CT
-CT
Internal Medicine, Geriatric MedicineIL
Marriage And Family TherapistCT

Reviews

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Frequently asked questions

What is the 10-digit NPI for DAIJSIA MELENA BUBB (APRN)?
DAIJSIA MELENA BUBB (APRN) — NPI 1023595725 — is the standard way to identify this listing.
Does the file indicate DAIJSIA MELENA BUBB (APRN) is practicing under active NPI?
Directory data currently reports DAIJSIA MELENA BUBB (APRN) as active.
What healthcare role does DAIJSIA MELENA BUBB (APRN) hold?
Scheduling teams often label DAIJSIA MELENA BUBB (APRN) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does DAIJSIA MELENA BUBB (APRN) list a practice location?
Patients near New Haven, Connecticut may find DAIJSIA MELENA BUBB (APRN) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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