NPIMap

Individual provider Active NPI

Jason D. Andrus, PA-C

  • Surgical Physician Assistant
  • Meriden, CT
National Provider Identifier
1104808369
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1011 Issued in CT
Practice address
435 Lewis Ave
Meriden, CT 06451-2101
Phone
(833) 203-7523
NPI assigned
Nov 15, 2005
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1011 CT Primary

Addresses

Primary practice location

435 Lewis Ave
Meriden, CT 06451-2101

Mailing address

435 Lewis Ave
Meriden, CT 06451-2101
Phone (833) 203-7523

Other practice location 1

84 N Main St Bldg 2
Branford, CT 06405-3061
Phone (203) 483-2024

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
I20060111001014 CT Practitioner - Physician Assistant 4688697055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.06 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001011CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Orthopaedic Specialists, PC CurrentSince Jun 30, 2025 Accepting new patients
Midstate Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Midstate Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Connecticut Orthopaedic Specialists, PC Surgical CurrentSince Jun 30, 2025 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
Trinity Health of New England Provider Network Organization Inc Past Accepting new patients
Hospital of Saint Raphael Past Accepting new patients
Comprehensive Orthopedics & Musculoskeletal Care LLC PastSince Jun 30, 2024 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Locations

84 N Main St
Bldg 2
Branford, CT 06405
Phone (203) 407-1500

2408 Whitney Ave
Hamden, CT 06518
Phone (203) 407-3500

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

1290 Silas Deane Hwy
Ste 102
Wethersfield, CT 06109

Organizations & group practices 10

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 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1104808369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "833-203-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "833-203-7523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 N Main St Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064053061",
            "country_code": "US",
            "telephone_number": "203-483-2024",
            "fax_number": "203-483-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "JASON",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "1011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.