Active NPI
Carla Jacobson-Kiel, MD
- Neonatal-Perinatal Medicine Physician
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 028314
- Practice address
- 114 Woodland St
Nicu
Hartford, CT 06105-1208 - Phone
- (860) 714-4404
- Fax
- (860) 714-8054
- NPI assigned
- Jul 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 028314 | CT | Primary |
Addresses
Primary practice location
114 Woodland St
Nicu
Hartford, CT 06105-1208
Mailing address
1000 Asylum Ave
Suite 2109a
Hartford, CT 06105-1770
Phone (860) 714-6581
Other practice location 1
282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-8950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001283142 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cjacobsonkiel15042@connecticutchildrens.direct-ci.com |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028314 | CT | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Connecticut Children'S Specialty Group, Inc. | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Connecticut Children'S Specialty Group, Inc. | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Prospect CT Medical Foundation, Inc. | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients |
Locations
1801 W Olympic Blvd
#2201
Pasadena, CA 91199
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118
263 Farmington Ave
Farmington, CT 06032
Phone (860) 679-1706
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619
80 Seymour St
Fl 5
Hartford, CT 06106
Phone (860) 545-8950
114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001
100 Retreat Ave
Fl 5
Hartford, CT 06106
Phone (860) 837-5206
71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981
18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557
435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340
100 Grand St
New Britain, CT 06052
Phone (860) 224-5011
34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
6 Fieldstone Cmns
Ste D
Tolland, CT 06084
Phone (860) 871-6710
1000 Asylum Ave
Ste 2109A
West Hartford, CT 06105
Phone (860) 714-5058
Interoperability endpoints
- cjacobsonkiel15042@connecticutchildrens.direct-ci.com
Organizations & group practices 6
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.
-
- Pediatrics Physician
- Hartford, CT
- NPI 1669448882
Neonatal-Perinatal Medicine
-
- Family Medicine Physician
- Manchester, CT
- NPI 1144677568
-
- Internal Medicine Physician
- Hartford, CT
- NPI 1003882812
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Ophthalmology Physician
- Glastonbury, CT
- NPI 1568056984
Neonatal-Perinatal Medicine
-
- Internal Medicine Physician
- Waterville, ME
- NPI 1134779531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1235137316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 ASYLUM AVE",
"address_2": "SUITE 2109A",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051770",
"telephone_number": "860-714-6581",
"fax_number": "860-714-8311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 WOODLAND ST",
"address_2": "NICU",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051208",
"telephone_number": "860-714-4404",
"fax_number": "860-714-8054"
}
],
"practiceLocations": [
{
"address_1": "282 Washington St",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061063322",
"country_code": "US",
"telephone_number": "860-545-8950",
"fax_number": "860-545-8959",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSON-KIEL",
"first_name": "CARLA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-12",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CT",
"license": "028314",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001283142",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cjacobsonkiel15042@connecticutchildrens.direct-ci.com",
"affiliation": "N",
"address_1": "282 Washington St",
"city": "Hartford",
"state": "CT",
"country_code": "US",
"postal_code": "061063322",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.