Jack A Schmetterling, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2045171 Issued in CT

Practice address

336 N Main St
West Hartford, CT 06117-2510

Phone

(860) 232-4891

Fax

(860) 263-1016

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Internal Medicine

  Medicare reassignment NPD
• Hartford Physician Services PC

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1346227774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 N MAIN ST",
            "address_2": "HARTFORD MEDICAL GROUP",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172510",
            "telephone_number": "860-232-4891",
            "fax_number": "860-236-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172510",
            "telephone_number": "860-232-4891",
            "fax_number": "860-263-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMETTERLING",
        "first_name": "JACK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "2045171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001267500",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernice Schaefer, PHD
• Janet Schaefer, MS, MBA, CDE, C D/N
• Sarah Elizabeth Schauer, NP
• Lynne Beverley Schenkel
• Carol G Schiffman, L.P.C.
• Janet B Schrager, PHD
• Amanda Schultz
• Kelly Schunder, MSW, LCSW
• Gavin Schwarz, M.D.
• Thomas Sciarra

• Internal Medicine Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.