Individual provider Active NPI

Jessica Caruso, PA

  • Physician Assistant
  • Hamden, CT
National Provider Identifier
1346624723
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3962 Issued in CT
Practice address
2080 Whitney Ave Ste 250
Hamden, CT 06518-3606
Phone
(203) 800-4471
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5439 MA
Physician Assistant 363A00000X 3962 CT Primary

Addresses

Primary practice location

2080 Whitney Ave Ste 250
Hamden, CT 06518-3606

Mailing address

2080 Whitney Ave Ste 250
Hamden, CT 06518-3606

Other practice location 1

1505 Memorial Dr
Chicopee, MA 01020-3900
Phone (413) 533-3049

Other names 1

  • Jessica Little Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5439MAMDMental Health Counselor
3962CTMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care Connecticut, P.C. CurrentSince Sep 1, 2017 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

68 Division St
Derby, CT 06418
Phone (203) 732-6802

Organizations & group practices 2

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1346624723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WHITNEY AVE STE 250",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WHITNEY AVE STE 250",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183606",
            "telephone_number": "203-800-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Chicopee",
            "state": "MA",
            "postal_code": "010203900",
            "country_code": "US",
            "telephone_number": "413-533-3049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "5439",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LITTLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.