MR. EDIN MEMISEVICH (NP) – Primary Care Nurse Practitioner, NPI 1992160105
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,196 NURSE PRACTITIONER in CT
Provider Addresses for MR. EDIN MEMISEVICH (NP)
1 LONG WHARF DR
NEW HAVEN, CT 065115946
Phone: (203) 781-4600
Fax: (203) 781-4624
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: 2024-11-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160226000306 | I | Nurse Practitioner | CT | TBD |
| I20210722002956 | I | Nurse Practitioner | NY | TBD |
| I20240419001355 | I | Nurse Practitioner | VT | TBD |
| I20240509002301 | I | Nurse Practitioner | ME | TBD |
| I20241101002233 | I | Nurse Practitioner | NJ | TBD |
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.
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 06511)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Psychiatry, Addiction Medicine, Addiction Medicine, Psychiatry | NY | |
| Psychiatry, Addiction Medicine, Addiction Medicine, Psychiatry | NM | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | NY | |
| Physician Assistant | NY | |
| Family Practice, Addiction Medicine | PA | |
| Family Practice, General Practice | OR | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA |
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