Individual provider Active NPI

Jennifer L Phung, APRN

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1316103542
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
003868 Issued in CT
Practice address
800 Howard Ave
New Haven, CT 06519-1369
Phone
(203) 785-7191
Fax
(203) 785-2917
NPI assigned
Aug 7, 2008
Last updated
Feb 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 061785 CT
Family Nurse Practitioner 363LF0000X 003868 CT Primary

Addresses

Primary practice location

800 Howard Ave
New Haven, CT 06519-1369

Mailing address

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-7191

Other names 1

  • Jennifer Laone Former name

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
I20081223000418 CT Practitioner - Nurse Practitioner 2466513908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003868CTMDClinical Psychologist
061785CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Mar 6, 2025 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Mar 6, 2025 Accepting new patients
Naugatuck Valley Cardiovascular Associates Family CurrentSince Nov 2, 2015 Accepting new patients

Locations

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

1625 Straits Tpke
Ste 209
Middlebury, CT 06762
Phone (203) 758-9100

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

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

Interoperability endpoints

  • Direct secure messaging: jphung@direct.wtbyhosp.org
  • Direct secure messaging: jphung10093@direct.ynhh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1316103542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-7191",
            "fax_number": "203-785-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-7191",
            "fax_number": "203-785-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "061785",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LAONE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.