NPIMap

Individual provider Active NPI

Jitesh Vachhani, M.D.

  • Internal Medicine Physician
  • Bristol, CT
National Provider Identifier
1205815487
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042907 Issued in CT
Practice address
41 Brewster Rd
Bristol, CT 06010-0977
Phone
(860) 585-3313
Fax
(860) 585-3454
NPI assigned
Jan 16, 2006
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042907 CT Primary
Hospitalist Physician 208M00000X 042907 CT

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06010-0977

Mailing address

41 Brewster Rd
Bristol, CT 06010-0977
Phone (860) 585-3313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000020 CT Practitioner - Internal Medicine 3274594585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

248 Flanders Rd
Niantic, CT 06357-1264
Phone (860) 739-5426

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042907CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients
Ipc Hospitalists of New England, P.C. Internal Medicine CurrentSince Nov 18, 2009 Accepting new patients
Ipc Hospitalists of New England PC Internal Medicine CurrentSince Nov 18, 2009 Accepting new patients
Ipc Hospitalists of New England, P.C. Internal Medicine Current Accepting new patients
Middlesex Hospital Past Accepting new patients
Cosmetic Laser Center of Rocky Hill Internal Medicine PastSince Jan 22, 2007 Accepting new patients
Sound Medical Associates, PC Internal Medicine Past Accepting new patients
Conncare Inc Internal Medicine Past Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

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

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

365 Montauk Ave
Rm 4
New London, CT 06320

248 Flanders Rd
Niantic, CT 06357
Phone (860) 739-5426

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: jvachhani188016@direct.ynhh.org

Organizations & group practices 9

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 6

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1205815487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060100977",
            "telephone_number": "860-585-3313",
            "fax_number": "860-585-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060100977",
            "telephone_number": "860-585-3313",
            "fax_number": "860-585-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHHANI",
        "first_name": "JITESH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "042907",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "042907",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.