BRETT ROBERTSON – Family Nurse Practitioner, NPI 1194100065

BRETT ROBERTSON is a healthcare provider. based in Willimantic, Connecticut. specializing in NURSE PRACTITIONER. They hold a License No. 6156 (CT). The NPI Number for BRETT ROBERTSON is 1194100065

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
BRETT ROBERTSON
NPI
1194100065
Phone
(860) 450-7471
Address
40 MANSFIELD AVE
Enumeration Date
21 July 2015
Last Update Date
21 July 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8604507471
Graduation Year
2015 (11 years ago)
PAC ID
5395052542
Group Practice PAC ID
4880640630
Professional Enrollment ID
I20150921001198
Address ID
CT062262018WI40XXXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

4,191 NURSE PRACTITIONER in CT

Provider Addresses for BRETT ROBERTSON

  • 40 MANSFIELD AVE

    WILLIMANTIC, CT 062262018

    Phone: (860) 450-7471

    Fax: (860) 450-0213

    Mailing address matches the actual address.

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: 2015-09-21

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
I20150921001198INurse 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 06226)

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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: 4880640630View full group profile

Reviews

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Frequently asked questions

How do I look up BRETT ROBERTSON by NPI?
Use NPI 1194100065 when you need to reference BRETT ROBERTSON in forms, claims, or directories.
Is BRETT ROBERTSON active in the national directory?
BRETT ROBERTSON's public NPI profile is in an active state.
What does BRETT ROBERTSON treat or focus on?
Patients typically see BRETT ROBERTSON under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for BRETT ROBERTSON?
The page summarizes Willimantic, Connecticut for BRETT ROBERTSON; expand the address list for detail.
Is BRETT ROBERTSON a real provider?
This page reflects official NPPES data for NPI 1194100065. Always confirm identity and privileges with the practice and licensing boards.

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