Individual provider Active NPI

Jodi Ambler

  • Physician Assistant
  • New Haven, CT
National Provider Identifier
1063945244
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3798 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Apr 5, 2017
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3798 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

430 E 63Rd St Apt 7D
New York, NY 10065-7925
Phone (989) 751-0705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210310000382 CT Practitioner - Physician Assistant 1951717354 Reassigns benefits to 1 organization
I20220803003040 DC Practitioner - Physician Assistant 1951717354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3798CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Mar 4, 2021 Accepting new patients
Children's Hospital CurrentSince Jul 20, 2022 Accepting new patients
Yale University CurrentSince Mar 4, 2021 Accepting new patients
Children's Hospital CurrentSince Jul 20, 2022 Accepting new patients
Children's Hospital Past Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 884-4177

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1063945244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E 63RD ST APT 7D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657925",
            "telephone_number": "989-751-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBLER",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2022-05-26",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.