Elevate Health and Wellness – Community/Behavioral Health Agency, NPI 1730623737

Elevate Health and Wellness is a healthcare provider. based in East haven, Connecticut. specializing in Community/Behavioral Health Agency. The NPI Number for Elevate Health and Wellness is 1730623737

Main info

Organization
Name
Elevate Health and Wellness
NPI
1730623737
Phone
(203) 887-3890
Address
19 ELLIS RD
Authorized Official
MOHAMED ELSAMRA OWNER AND MANAGER MD
Enumeration Date
9 December 2016
Last Update Date
3 August 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness80
Years active:9State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Elevate Health and Wellness

  • 19, Ellis Road, East Haven, New Haven County, Connecticut, 06512, United States

    EAST HAVEN, CT 065124627

    Phone: (203) 887-3890

    Type: Mailing

  • 53, Riverside Avenue, Westport, Fairfield County, Connecticut, 06880, United States

    WESTPORT, CT 068804215

    Phone: (203) 887-3890

    Type: Location

  • 179 POST RD W

    WESTPORT, CT 068804602

    Phone: (203) 450-4882

    Fax: (866) 505-8927

    Type: Mailing

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: 2024-03-14

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
O20240314000324OClinic/Group PracticeCTTBD

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 06512)

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Reviews

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Frequently asked questions

What NPI should I save for Elevate Health and Wellness?
Save NPI 1730623737 if you need a stable reference for Elevate Health and Wellness.
Is Elevate Health and Wellness's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does Elevate Health and Wellness work in?
You can think of Elevate Health and Wellness as practicing within Community/Behavioral Health Agency. Clinical services aligned with this taxonomy classification.
What location shows for Elevate Health and Wellness?
We surface East Haven, Connecticut for Elevate Health and Wellness based on available NPPES addresses.
Is Elevate Health and Wellness a real provider?
This page reflects official NPPES data for NPI 1730623737. Always confirm identity and privileges with the practice and licensing boards.

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