Individual provider Active NPI

Jessica Andraszek

  • Gerontology Nurse Practitioner
  • Stamford, CT
National Provider Identifier
1124880505
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
12.012837 Issued in CT
Practice address
90 Morgan St Ste 105
Stamford, CT 06905-5436
Phone
(203) 898-0016
NPI assigned
Jan 30, 2024
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 12.012837 CT Primary

Addresses

Primary practice location

90 Morgan St Ste 105
Stamford, CT 06905-5436

Mailing address

90 Morgan St Ste 105
Stamford, CT 06905-5436

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412001855 CT Practitioner - Nurse Practitioner 7012356827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

90 Morgan St
Suite 105
Stamford, CT 06905-5436
Phone (203) 276-7215

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.012837CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc CurrentSince Apr 15, 2024 Accepting new patients

Locations

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

90 Morgan St
Ste 105
Stamford, CT 06905
Phone (203) 276-2435

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA
  • Direct secure messaging: jandraszek26500@stamfordhealth.direct-ci.com

Organizations & group practices 1

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 1

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1124880505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MORGAN ST STE 105",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MORGAN ST STE 105",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055436",
            "telephone_number": "203-898-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRASZEK",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12.012837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.