NPIMap

Organization Active NPI

Jeffrey P. Thompsen, M.D., LLC

  • Cardiovascular Disease Physician
  • Enfield, CT
National Provider Identifier
1003841065
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
41802 Issued in CT
Legal business name
JEFFREY P. THOMPSEN, M.D., LLC
Practice address
15 Palomba Drive
Suite 11
Enfield, CT 06082
Phone
(860) 253-9950
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Juanita Green
Title
Office Manager
Phone
(860) 545-5061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 41802 CT Primary

Addresses

Primary practice location

15 Palomba Drive
Suite 11
Enfield, CT 06082

Mailing address

15 Palomba Dr
Ste. 11
Enfield, CT 06082-3888
Phone (860) 253-9950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060726000128 CT Part B Supplier - Clinic/Group Practice 0345253985 Receives reassigned benefits from 5 practitioners
Practice locations: Vernon, CT; Windsor, CT; Enfield, CT

National Provider Directory

National Provider Directory

Locations

15 Palomba Dr
Ste 2
Enfield, CT 06082
Phone (860) 253-9950

831 Boston Post Rd
Fl 2
Milford, CT 06460

5 Magauran Dr
Ste 3
Stafford Springs, CT 06076

7 Magauran Dr
Ste 2
Stafford Springs, CT 06076
Phone (860) 684-3745

851 Marshall Phelps Rd
Windsor, CT 06095
Phone (860) 683-0756

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003841065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PALOMBA DR",
            "address_2": "STE. 11",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823888",
            "telephone_number": "860-253-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PALOMBA DRIVE",
            "address_2": "SUITE 11",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "06082",
            "telephone_number": "860-253-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY P. THOMPSEN, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-545-5061"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "41802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.