Individual provider Active NPI

Jaime P Mobiglia, PA-C

  • Surgical Physician Assistant
  • Danbury, CT
National Provider Identifier
1124344189
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001343 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 739-4900
Fax
(203) 739-1890
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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 001343 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 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
I20101116000373 CT Practitioner - Physician Assistant 6800081837 Reassigns benefits to 1 organization
I20191112001770 NY Practitioner - Physician Assistant 6800081837 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Hospital CurrentSince Sep 18, 2018 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

Interoperability endpoints

  • Direct secure messaging: jmobiglia160308@direct.ynhh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1124344189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-4900",
            "fax_number": "203-739-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-4900",
            "fax_number": "203-739-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBIGLIA",
        "first_name": "JAIME",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.