Jacqueline Andria Dietrich

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8199 Issued in CT

Practice address

809 Main St
East Hartford, CT 06108-3117

Phone

(860) 528-1359

NPI assigned

Sep 8, 2019

Last updated

Sep 8, 2019By 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Careconnectmd Connecticut PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Stamford, CT
  • NPI 1467187336
  Medicare reassignment NPD
• HDC Care Solutions, LLC

  • Nurse Practitioner
  • Framingham, MA
  • NPI 1033861349

  CT, Family

  Medicare reassignment NPD

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567900800000",
    "number": "1285283747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083117",
            "telephone_number": "860-528-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083117",
            "telephone_number": "860-528-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "JACQUELINE",
        "middle_name": "ANDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2019-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jadalise L Devone
• Lisa Ellen Dewitt, LCSW
• Cynthia J Dezi, APRN, CRNA
• Peter H Diamond, M.D.
• Ashley M Diaz
• Jorge L. Diez, MD
• Joseph Arthur Digiuseppe, M.D.
• Dignity Solutions
• Dilligence Training
• Anthony Dominick Dinardo, DMD

• Family Nurse Practitioner in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; 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.

Verify at the official NPI Registry.