Individual provider Active NPI

Jessica Webster Macrie, DO

  • Family Medicine Physician
  • Suite 1, CT
National Provider Identifier
1033309588
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64340 Issued in CT
Practice address
73 Waterbury Road
Suite 1, CT 06109-4337
Phone
(203) 527-9444
Fax
(203) 527-9332
NPI assigned
Jul 31, 2007
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 134164 NC
Family Medicine Physician 207Q00000X 64340 CT Primary

Addresses

Primary practice location

73 Waterbury Road
Suite 1, CT 06109-4337

Mailing address

1290 Silas Deane Hwy FL 1
Wethersfield, CT 06109-4337
Phone (860) 972-6970

Other identifiers 1

IdentifierTypeStateIssuer
64340OtherCTCT LIC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201008000920 CT Practitioner - Family Practice 7416096631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

73 Waterbury Rd
Prospect, CT 06712-1252
Phone (203) 527-9444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.48 of 100Reported as apm
Quality
83.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
134164NCMDCardiovascular Disease Physician
00637NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Oct 1, 2020 Accepting new patients

Locations

73 Waterbury Rd
Prospect, CT 06712
Phone (203) 527-9130

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Fl 1
Wethersfield, CT 06109
Phone (860) 972-6970

Interoperability endpoints

  • Direct secure messaging: jessica.macrie@xdr.hhchealthdirect.org

Organizations & group practices 1

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1033309588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY FL 1",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-6970",
            "fax_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 WATERBURY ROAD",
            "city": "SUITE 1",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "203-527-9444",
            "fax_number": "203-527-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACRIE",
        "first_name": "JESSICA",
        "middle_name": "WEBSTER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "134164",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "64340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LIC",
            "identifier": "64340",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.