NPIMap

Individual provider Active NPI

Denisse Burgos-Jimenez

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1013455351
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3767 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706
Phone
(860) 989-6067
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3767 CT
Medical Physician Assistant 363AM0700X 3767 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706

Mailing address

841 New Britain Ave
Hartford, CT 06106-3920

Other practice location 1

816 Broad St Ste 24
Meriden, CT 06450-4350
Phone (888) 344-0007

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dburgosjimenez280989@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170223001817 CT Practitioner - Physician Assistant 6002190774 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Nov 1, 2024 Accepting new patients
Cep America LLC CurrentSince Apr 7, 2025 Accepting new patients
State of Connecticut CurrentSince Nov 1, 2024 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 27, 2022 Accepting new patients
Cep America LLC CurrentSince Apr 7, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: denisse.burgos-jimenez@xdr.hhchealthdirect.org
  • Direct secure messaging: dburgosjimenez2389342@direct.trinity-health.org
  • Direct secure messaging: dburgosjimenez83620@direct.med.uchc.edu

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1013455351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 NEW BRITAIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06706",
            "telephone_number": "860-989-6067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "816 Broad St Ste 24",
            "address_purpose": "LOCATION",
            "city": "Meriden",
            "state": "CT",
            "postal_code": "064504350",
            "country_code": "US",
            "telephone_number": "888-344-0007",
            "fax_number": "203-238-1922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGOS-JIMENEZ",
        "first_name": "DENISSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3767",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dburgosjimenez280989@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "56 Franklin St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.