Jayme Marie Clark, PA-C

Individual provider Active NPI Medical Physician Assistant · South Windsor, CT

NPI 1306115142 · NPPES record last updated Nov 30, 2012

Key facts

NPI
1306115142
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
002685 (CT)
Practice address
2800 Tamarack Ave
Suite 104
South Windsor, CT 06074-5539
Phone
(860) 648-4480
Fax
(860) 648-2132
NPI assigned
Dec 23, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLC (1,555 clinicians)

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

85 Seymour St
Hartford, CT 06106-5501
Phone (860) 696-4306

Merit-based Incentive Payment System (MIPS)

Final score
94.48 of 100 (apm)
Quality
83.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100 (group)
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120213000037 CT Practitioner - Physician Assistant 9830356328 Reassigns benefits to 5 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002685CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Current
since Dec 1, 2020
Accepting new patients
Hartford Healthcare Medical Group, Inc Current
since Dec 4, 2017
Accepting new patients
St. Vincents Urgent Care LLC Current
since Apr 1, 2020
Accepting new patients
Hartford Healthcare Medical Group Specialists LLC Current
since Dec 1, 2020
Accepting new patients
SVMC Holdings, Inc Past Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Medical Past Accepting new patients
Eastern Connecticut Medical Professionals Foundation, Inc Past Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

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

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

7365 Main St
Ste 7
Stratford, CT 06614
Phone (203) 696-3505

2890 Main St
Ste 2A
Stratford, CT 06614
Phone (203) 378-3696

17 Church Hill Rd
Trumbull, CT 06611
Phone (203) 261-0800

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: jayme.clark@xdr.hhchealthdirect.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002685 CT Yes

Addresses

Primary practice location

2800 Tamarack Ave
Suite 104
South Windsor, CT 06074-5539

Mailing address

PO Box 3252
Vernon, CT 06066-2152
Phone (860) 896-1422

Other providers in South Windsor, CT

All providers in South Windsor, CT · Medical Physician Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.