Individual provider Active NPI

Jennifer Marie Martin

  • Family Nurse Practitioner
  • Woodbridge, CT
National Provider Identifier
1295347110
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9034 Issued in CT
Practice address
8 Lunar Dr
Woodbridge, CT 06525-2352
Phone
(203) 397-5211
NPI assigned
Aug 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9034 CT Primary

Addresses

Primary practice location

8 Lunar Dr
Woodbridge, CT 06525-2352

Mailing address

8 Lunar Dr
Woodbridge, CT 06525-2352
Phone (203) 397-5211

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jaldieri8814@direct.connecticutchildrens.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211105001843 CT Practitioner - Nurse Practitioner 2365831724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Children'S Specialty Group, IncGroup PAC ID 6002720117, 144 clinicians

Practice addresses (Care Compare)

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9034CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Nov 1, 2021 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Nov 1, 2021 Accepting new patients
Sydney Z Spiesel PHD MD LLC Pediatrics PastSince Aug 23, 2020 Accepting new patients

Locations

599 Farmington Ave
Farmington, CT 06032
Phone (860) 284-4945

599 Farmington Ave
Ste 202
Farmington, CT 06032
Phone (860) 837-5170

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

Organizations & group practices 3

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": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1295347110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LUNAR DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252352",
            "telephone_number": "203-397-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LUNAR DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252352",
            "telephone_number": "203-397-5211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaldieri8814@direct.connecticutchildrens.org",
            "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 Woodbridge, CT

Sources for this page

Verify at the official NPI Registry.