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VIVID AESTHETICS & WELLNESS PLLC
NPI 1861260671
Family Medicine in Cromwell, CT

Active since December 12, 2023
110 COURT ST, CROMWELL, CT 06416(860) 250-9017 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 6, 2024, Dec 12, 2023 (2 updates tracked since 2023).

About Vivid Aesthetics & Wellness Pllc NPPES

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

VIVID AESTHETICS & WELLNESS PLLC (NPI 1861260671) is a healthcare organization registered as a family medicine in Cromwell, Connecticut and active in the NPI registry since December 2023. The organization maintains a secondary practice location in Newington and lists Selma Costa Rosa, Nurse Practioner, as its authorized official.

NPPES Registry Identity

NPI1861260671
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameVIVID AESTHETICS & WELLNESS PLLC
Location Address110 COURT STCromwell, CT 06416-1273
Mailing Address110 Court StCromwell, CT 06416-1273
Phone(860) 250-9017
Organization SubpartNo
Authorized OfficialSelma Costa RosaNurse Practioner · (860) 250-9017
Enumeration DateDecember 12, 2023
Last NPPES UpdateDecember 6, 20242 updates tracked since enumeration
NPPES CertifiedDecember 6, 2024
✔ NPI 1861260671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
110 COURT ST, Cromwell, CT 06416
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Secondary Practice Location 1

Location 1117 Dowd StNewington, CT 06111-2608 · Phone (860) 250-9017

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vivid Aesthetics & Wellness Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Vivid Aesthetics & Wellness PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Brian Gomes, APRN
Nurse Practitioner
NPI 1669972444
110 COURT ST STE 2B
Cromwell, CT 06416
(860) 740-2016
✔ PECOS✔ Accepts MedicareSame address
Lynn Swanson, APRN
Nurse Practitioner
NPI 1073082343
534 TOLL GATE RD
Berlin, CT 06037
(860) 916-9124
✔ PECOS✔ Accepts Medicare5.1 mi
Selma Rosa, FNP-BC
Nurse Practitioner
NPI 1457930158
117 DOWD ST
Newington, CT 06111
(860) 250-9017
✔ PECOS✔ Accepts Medicare6.2 mi

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

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 Vivid Aesthetics & Wellness PLLC's NPI number?

The NPI number for Vivid Aesthetics & Wellness PLLC is 1861260671. It was assigned to this organization in the NPPES registry on December 12, 2023.

Where is Vivid Aesthetics & Wellness PLLC located?

Vivid Aesthetics & Wellness PLLC is located at 110 Court St, Cromwell, CT 06416. The listed phone number is (860) 250-9017.

What is Vivid Aesthetics & Wellness PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vivid Aesthetics & Wellness PLLC enrolled in Medicare?

Yes. Vivid Aesthetics & Wellness PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vivid Aesthetics & Wellness PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Vivid Aesthetics & Wellness PLLC. A 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 the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Vivid Aesthetics & Wellness PLLC was last updated on December 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.