Individual provider Active NPI

Jacque Ciarlo, D.O.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1255622759
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
054026 Issued in CT
Practice address
205 E 95TH St
Apartment 25 C
New York, NY 10128-4014
Phone
(203) 565-9361
NPI assigned
May 2, 2011
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N9441 TX
Emergency Medicine Physician 207P00000X 054026 CT Primary

Addresses

Primary practice location

205 E 95TH St
Apartment 25 C
New York, NY 10128-4014

Mailing address

205 E 95TH St
Apartment 25 C
New York, NY 10128-4014
Phone (203) 565-9361

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
I20151001000687 CT Practitioner - Emergency Medicine 7911177365 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.05 of 100Reported as group
Quality
84.92
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.01 of 100Reported as group
Quality
71.79
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Emergency Medicine CurrentSince Jul 23, 2015 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Feb 1, 2021 Accepting new patients
Nems PLLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Usacs of Connecticut, LLC Emergency Medicine CurrentSince Aug 2, 2023 Accepting new patients
The William W Backus Hospital CurrentSince Apr 1, 2018 Accepting new patients
William W Backus Hospital CurrentSince Apr 1, 2018 Accepting new patients
Emergency Physicians of Connecticut PC Emergency Medicine CurrentSince Jun 6, 2018 Accepting new patients
Northeast Emergency Medicine Specialists, LLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Feb 1, 2021 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients
Abk Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

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

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: jacque.ciarlo@xdr.hhchealthdirect.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1255622759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E 95TH ST",
            "address_2": "APARTMENT 25 C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284014",
            "telephone_number": "203-565-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 95TH ST",
            "address_2": "APARTMENT 25 C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284014",
            "telephone_number": "203-565-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARLO",
        "first_name": "JACQUE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N9441",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "054026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.