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BROOKLYN LARISA MICKOLYZCK DNP, FNP-BC
NPI 1376226613
Nurse Practitioner - Family in Middletown, CT

Active since August 11, 2023PECOS EnrolledAccepts Medicare Assignment
11 S MAIN ST, MIDDLETOWN, CT 06457(860) 347-4555 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 25, 2024, Aug 11, 2023 (2 updates tracked since 2023).

About Brooklyn Larisa Mickolyzck Dnp, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKLYN LARISA MICKOLYZCK DNP, FNP-BC (NPI 1376226613) is an individual family provider in Middletown, Connecticut, licensed in Connecticut (13616) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1376226613
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBROOKLYN LARISA MICKOLYZCKCredential: DNP, FNP-BC
Location Address11 S MAIN STMiddletown, CT 06457-3656
Mailing Address30 George StNorth Haven, CT 06473-1855 · (203) 641-3059
Phone(860) 347-4555
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 11, 2023
Last NPPES UpdateSeptember 25, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2024
✔ NPI 1376226613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CT · 13616
11 S MAIN ST, Middletown, CT 06457
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brooklyn Larisa Mickolyzck Dnp, Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163955139
PECOS Enrollment IDI20241029003231
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERIC JOSEPH THOMAS M.D.
Dermatology (Procedural Dermatology)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555
DR. SUSAN REBECCA UBER
Psychologist (Clinical)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4633
DR. MARC DAVID ARONSON M.D.
Psychiatry & Neurology (Psychiatry)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-2366
MRS. DONNA HARVEY RAMAGE LCSW
Counselor (Mental Health)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 227-8522
BLUE HILLS BEHAVIORAL HEALTH
Psychiatry & Neurology (Psychiatry)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 852-3860
MIDDLESEX DERMATOLOGY, LLC
Dermatology
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555
MIDDLESEX NEUROPSYCHIATRIC CENTER
Psychiatry & Neurology (Psychiatry)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-2366
INTEGRATED DERMATOLOGY OF MIDDLETOWN, PLLC
Dermatology
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooklyn Mickolyzck's NPI number?

The NPI number for Brooklyn Mickolyzck is 1376226613. It was assigned to this individual provider in the NPPES registry on August 11, 2023.

Where is Brooklyn Mickolyzck located?

Brooklyn Mickolyzck practices at 11 S Main St, Middletown, CT 06457. The listed phone number is (860) 347-4555.

What is Brooklyn Mickolyzck's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Brooklyn Mickolyzck enrolled in Medicare?

Yes. Brooklyn Mickolyzck is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Brooklyn Mickolyzck was last updated on September 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.