Jacqueline Clarizio

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4820 Issued in CT

Practice address

5520 Park Ave Ste 300
Trumbull, CT 06611-3465

Phone

(203) 374-0310

NPI assigned

Oct 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1174166722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE STE 300",
            "address_2": "WEST PAVILION",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE STE 300",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113465",
            "telephone_number": "203-374-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "646 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656105",
            "country_code": "US",
            "telephone_number": "800-633-8446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Mineola Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "115772042",
            "country_code": "US",
            "telephone_number": "800-633-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARIZIO",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "024317",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Rachelle Christensen, D.O.
• Ayanna Johnese Christian
• Michelle Lynne Ciccarelli, OTR/L
• Cara Elizabeth Cifarelli, RPH
• Frank Angelo Ciminiello, MD
• Clearpaths Counseling LLC
• Trisha Cleary, OTR/L
• George M Cody, LCSW-C
• Megan Bennett Cohan
• Isaac Cohen, M.D.

• Surgical Physician Assistant in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.