Jodi Ambler – Physician Assistant in New Haven, CT

Key facts

NPI: 1063945244
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 3798 (CT)
Practice address: 20 York St
New Haven, CT 06510-3220
Phone: (203) 688-4242
NPI assigned: Apr 5, 2017
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Yale University Anesthesiology Physician · New Haven, CT · NPI 1205822236

Medicare reassignment NPD CT
Children'S Hospital Children's Hospital · Washington, DC · NPI 1912939703

Medicare reassignment NPD (past) DC
Yale University Durable Medical Equipment & Medical Supplies · Fairfield, CT · NPI 1548066962

NPD
Children'S Hospital Community/Retail Pharmacy · Silver Spring, MD · NPI 1326878349

NPD
Children'S Hospital Pediatrics Physician · Washington, DC · NPI 1780800128

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in CT, DC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
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

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
3798	CT	MD	Physician Assistant

Practice roles

Organization	Status	New patients
Children'S Hospital	Current since Jul 20, 2022	Accepting new patients
Yale University	Current since Mar 4, 2021	Accepting new patients
Yale University	Current since Mar 4, 2021	Accepting new patients
Children'S Hospital	Current since Jul 20, 2022	Accepting new patients
Children'S Hospital	Past	Accepting new patients

Locations

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

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

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

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	3798	CT	Yes

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

Other providers in New Haven, CT

All providers in New Haven, CT · Physician Assistant in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.