Jackilyn Annelli, PA

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

6548 Issued in CT

Practice address

12 Case St Ste 212
Norwich, CT 06360-2222

Phone

(860) 859-9123

Fax

(860) 859-9124

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

New England Rheumatology LLCGroup PAC ID 7113168113, 2 clinicians

Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
• William W Backus Hospital Hospital, Norwich, CT, CCN 070024
• Day Kimball Hospital Hospital, Putnam, CT, CCN 070003
• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jackilyn.anneli@xdr.hhchealthdirect.org

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.

• New England Rheumatology LLC

  • Rheumatology Physician
  • Norwich, CT
  • NPI 1013258664
  Medicare reassignment Care Compare group

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

• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1205056371
  Care Compare affiliation
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235
  Care Compare affiliation
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718
  Care Compare affiliation
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  Care Compare affiliation

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1245085315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CASE ST STE 212",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-859-9123",
            "fax_number": "860-859-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CASE ST STE 212",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-859-9123",
            "fax_number": "860-859-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNELLI",
        "first_name": "JACKILYN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CT",
            "license": "6548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Anderson
• Nancy Anderson, PHD
• Sophia Elizabeth Andrew, PA-C
• Katherine Andrias, LMFT
• Larisa Anisimov, RDH
• Sherida Antonacci, LCSW
• Maria Aponte, BA
• Kyah Suiko Arcayan
• James W Aree
• Amanda Armstrong, LCSW

• Rheumatology Physician in Norwich, CT
• Providers in Norwich, CT by specialty
• Rheumatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.