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MARANDA GOURLEY MPH, MSN, PNP-PC
NPI 1730713512
Nurse Practitioner - Pediatrics in New Haven, CT

Active since March 02, 2020PECOS Enrolled
50 GRAND AVE, NEW HAVEN, CT 06513(203) 777-7411 Get Directions Write a Review

NPPES record last updated: February 9, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 9, 2021, Jul 29, 2020, Mar 2, 2020 (3 updates tracked since 2020).

About Maranda Gourley Mph, Msn, Pnp-pc NPPES

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

MARANDA GOURLEY MPH, MSN, PNP-PC (NPI 1730713512) is an individual pediatrics provider in New Haven, Connecticut, licensed in Connecticut (9041) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in New Haven.

NPPES Registry Identity

NPI1730713512
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMARANDA GOURLEYCredential: MPH, MSN, PNP-PC
Location Address50 GRAND AVENew Haven, CT 06513-3949
Mailing Address226 Bishop St Fl 3New Haven, CT 06511-3718 · (507) 450-8262
Phone(203) 777-7411
Sole ProprietorNo
Enumeration DateMarch 2, 2020
Last NPPES UpdateFebruary 9, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2021
✔ NPI 1730713512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CT · 9041
Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License 153396 (CT)
50 GRAND AVE, New Haven, CT 06513
Open in Google Maps ↗

Other Names 1

Former Name (1)Maranda Hyde

Secondary Practice Location 1

Location 155 Lock StNew Haven, CT 06511-3603 · Phone (203) 432-0206

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maranda Gourley Mph, Msn, Pnp-pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Maranda Gourley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fair Haven Community Health Clinic, Inc
Same address
Federally Qualified Health Center (FQHC)
50 GRAND AVE
New Haven, CT 06513
  • Reassigned Medicare billing, Connecticut enrollment
  • 73 clinicians in this Medicare group
NPI 1811372469 (203) 777-7411

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06513 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 9

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

ESTHEFFY GONZALEZ PANTALEON
Dental Hygienist
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
ALYSSA BIRMINGHAM RDH
Dental Hygienist
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
SAMANTHA NEBIOLO
Advanced Practice Midwife
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
ANNETTE LILIANNA NASIADKA RDH
Dental Hygienist
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
DR. ANN NAKAI JUREWICZ DPM
Podiatrist (Foot & Ankle Surgery)
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
DR. SPRETHA KADAVATH D.D.S
Dentist
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
IRENE MATURO RDH
Dental Hygienist
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 974-0121
DR. GEORGE MURPHY DMD
Dentist (General Practice)
50 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 974-0121

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 Maranda Gourley's NPI number?

The NPI number for Maranda Gourley is 1730713512. It was assigned to this individual provider in the NPPES registry on March 2, 2020. The provider is also known as Maranda Hyde.

Where is Maranda Gourley located?

Maranda Gourley practices at 50 Grand Ave, New Haven, CT 06513. The listed phone number is (203) 777-7411.

What is Maranda Gourley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Maranda Gourley enrolled in Medicare?

Yes. Maranda Gourley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Maranda Gourley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maranda Gourley reassigns Medicare benefits to Fair Haven Community Health Clinic, Inc (New Haven, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maranda Gourley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maranda Gourley accept?

Health plans from Anthem Blue Cross and Blue Shield list Maranda Gourley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maranda Gourley was last updated on February 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.