Individual provider Active NPI

Carla Jacobson-Kiel, MD

  • Neonatal-Perinatal Medicine Physician
  • Hartford, CT
National Provider Identifier
1235137316
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
028314 Issued in CT
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

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001283142MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000530 CT Practitioner - Pediatric Medicine 4486798162 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028314CTMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 30, 2013 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Neonatal-Perinatal Medicine CurrentSince May 1, 2014 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Neonatal-Perinatal Medicine CurrentSince May 1, 2014 Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 30, 2013 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.