NPIMap

Individual provider Active NPI

Jayme Marie Clark, PA-C

  • Medical Physician Assistant
  • South Windsor, CT
National Provider Identifier
1306115142
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002685 Issued in 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
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

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

Care Compare profile

Medicare Care Compare
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 PLLCGroup PAC ID 3173866241, 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 100Reported as apm
Quality
83.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002685CTMDMedical Physician Assistant

Practice roles

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

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

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

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

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, 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": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1306115142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3252",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662152",
            "telephone_number": "860-896-1422",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TAMARACK AVE",
            "address_2": "SUITE 104",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745539",
            "telephone_number": "860-648-4480",
            "fax_number": "860-648-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAYME",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-23",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "002685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.