Individual provider Active NPI

Jay E Hellreich, MD

  • Ophthalmology Physician
  • Meriden, CT
National Provider Identifier
1114927332
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
028996 Issued in CT
Practice address
546 S Broad St
Meriden, CT 06450-6600
Phone
(203) 235-2511
Fax
(203) 639-0809
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 028996 CT Primary

Addresses

Primary practice location

546 S Broad St
Meriden, CT 06450-6600

Mailing address

546 S Broad St
Meriden, CT 06450-6600
Phone (203) 235-2511

Other identifiers 6

IdentifierTypeStateIssuer
001289968MedicaidCT
0R0103OtherCTHEALTH NET
180008284OtherCTRAILROAD MEDICARE
010028996CT01OtherCTANTHEM
NHS396OtherCTOXFORD
028996OtherCTCONNECTICARE

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
I20100420000984 CT Practitioner - Ophthalmology 2860540937

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028996CTMDOphthalmology Physician

Interoperability endpoints

  • Direct secure messaging: jay.hellreich@xdr.hhchealthdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1114927332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 S BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506600",
            "telephone_number": "203-235-2511",
            "fax_number": "203-639-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 S BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506600",
            "telephone_number": "203-235-2511",
            "fax_number": "203-639-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLREICH",
        "first_name": "JAY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "028996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001289968",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0R0103",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180008284",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010028996CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NHS396",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "028996",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.