Individual provider Active NPI

Janet Prisca Djentuh, CNM

  • Advanced Practice Midwife
  • Norwalk, CT
National Provider Identifier
1194796870
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000254 Issued in CT
Practice address
121 Water St
Norwalk, CT 06854-3013
Phone
(203) 899-1770
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 000254 CT Primary

Addresses

Primary practice location

121 Water St
Norwalk, CT 06854-3013

Mailing address

24 Stevens St
Norwalk, CT 06850-3852
Phone (203) 852-2353

Other identifiers 3

IdentifierTypeStateIssuer
004239647MedicaidCT
2V2653OtherCTHEALTHN ET
400000254CT01OtherCTANTHEM B/C

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000507 CT Practitioner - Certified Nurse Midwife (CNM) 1658404892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000254CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Jan 5, 2015 Accepting new patients
Norwalk Community Health Center Inc Past Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

38 East Ave
New Canaan, CT 06840
Phone (203) 594-9520

30 Stevens St
Norwalk, CT 06850
Phone (203) 852-2262

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD

Organizations & group practices 2

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1194796870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 STEVENS ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503852",
            "telephone_number": "203-852-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WATER ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068543013",
            "telephone_number": "203-899-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJENTUH",
        "first_name": "JANET",
        "middle_name": "PRISCA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004239647",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHN ET",
            "identifier": "2V2653",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM B/C",
            "identifier": "400000254CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.