NPIMap

Individual provider Active NPI

Andrew Jimenez

  • Sports Medicine (Orthopaedic Surgery) Physician
  • New Haven, CT
National Provider Identifier
1174943369
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
63795 Issued in CT
Practice address
47 College St FL 2
New Haven, CT 06510-3209
Phone
(877) 925-3637
Fax
(203) 785-6798
NPI assigned
Apr 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 63795 CT Primary

Addresses

Primary practice location

47 College St FL 2
New Haven, CT 06510-3209

Mailing address

47 College St FL 2
New Haven, CT 06510-3209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200716003468 IL Practitioner - Orthopedic Surgery 6406073683 Reassigns benefits to 1 organization
I20211110003108 CT Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 6406073683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

300 Seaside Ave
Milford, CT 06460-4603
Phone (203) 876-4000

6 Devine St
North Haven, CT 06473-2195
Phone (203) 287-6100

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Home health agency, Milford, CT, CCN 077143
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
  • Gaylord Hospital Inc Long-term care hospital, Wallingford, CT, CCN 072003

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Nov 4, 2021 Accepting new patients
Yale University Sports Medicine CurrentSince Nov 4, 2021 Accepting new patients
University of Cincinnati Medical Center Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: ajimenez540953@direct.ynhh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1398470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1174943369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 COLLEGE ST FL 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 COLLEGE ST FL 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103209",
            "telephone_number": "877-925-3637",
            "fax_number": "203-785-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-26",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CT",
            "license": "63795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.