Suni Jacob, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

003301 Issued in CT

Practice address

2543 Dixwell Ave
Hamden, CT 06514-1860

Phone

(203) 230-4160

NPI assigned

Nov 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family and Internal Medicine of Dixwell AvenueGroup PAC ID 8527148550, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ECCCBA
• FHIR API: https://fhir4.healow.com/fhir/r4/ECCCBA/Endpoint/ECCCBA
• Direct secure messaging: suni.jacob@fimd.eclinicaldirectplus.com

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.

• Family and Internal Medicine of Dixwell Avenue

  • Internal Medicine Physician
  • Hamden, CT
  • NPI 1962681684
  Medicare reassignment Care Compare group NPD
• NP Care, LLC

  • Internal Medicine Physician
  • Shelton, CT
  • NPI 1326238866
  NPD (past)
• NP Care, LLC

  • Nurse Practitioner
  • Shelton, CT
  • NPI 1386693182
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1194709402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 ROCHELA DR",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064894671",
            "telephone_number": "203-525-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141860",
            "telephone_number": "203-230-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SUNI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "003301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008043065",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy L Isselee, DPT
• Claire Alexine Jackson
• Faith Jackson
• Krystina Jackson
• Nayamka Jackson
• Ayana Jacobs, LPN
• Wendy Shaw Jacoby
• Amanda Lynn Jeffreys
• Sheila Jelley, PA
• Athena M. Jenkins, LCSW/RN

• Nurse Practitioner in Hamden, CT
• Providers in Hamden, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.