Juliet Alexandra Jackson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

52906 Issued in CT

Practice address

2800 Main St
Bridgeport, CT 06606-4292

Phone

(203) 576-6000

NPI assigned

Apr 8, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Juliet Alexandra Georgetti Former name

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

Specialty

Anesthesiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integrated Anesthesia Associates LLC

  • Anesthesiology Physician
  • Shelton, CT
  • NPI 1881636397
  Medicare reassignment Care Compare group NPD
• Harbor Point Anesthesia LLC

  • Anesthesiology Physician
  • Stamford, CT
  • NPI 1043750532
  Medicare reassignment NPD
• Stamford Anesthesiology Services, PC

  • Anesthesiology Physician
  • Stamford, CT
  • NPI 1376608448
  Medicare reassignment NPD

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1124261086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DRIVE",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "203-929-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064292",
            "telephone_number": "203-576-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 East 68th Street",
            "address_2": "Department of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10065",
            "country_code": "US",
            "telephone_number": "212-746-2941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIET",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "267424-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "52906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIET",
            "last_name": "GEORGETTI",
            "middle_name": "ALEXANDRA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clifford Ives
• Ivey Lead Nursing Services, LLC
• Iya Therapy and Wellness PLLC
• Sumedh Krishna Iyengar, MD
• Jackqueline McLean DDS LLC
• Marcus Kirk Jackson, LCSW
• Natacha Jackson
• Samyiah Destiny Jackson
• Tatiana Y Jackson
• Jack Jacob, D.O.

• Anesthesiology Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Anesthesiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.