Active NPI
Elizabeth Jentzen, RN
- Midwife
- Stamford, CT
National Provider Identifier
1346859923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 501
- Practice address
- 1275 Summer St
Stamford, CT 06905-5359 - Phone
- (203) 978-5775
- NPI assigned
- Jul 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 501 | CT | Primary |
| Registered Nurse | 163W00000X | 143279 | CT |
Addresses
Primary practice location
1275 Summer St
Stamford, CT 06905-5359
Mailing address
3231 Town Walk Dr
Hamden, CT 06518-3706
Phone (203) 427-1624
Other practice location 1
3231 Town Walk Dr
Hamden, CT 06518-3706
Phone (203) 427-1624
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
50 Division St
New Haven, CT 06511-1936
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143279 | CT | MD | Registered Nurse |
| 501 | CT | MD | Hearing Instrument Specialist |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- New Haven, CT
- NPI 1205822236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1346859923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3231 TOWN WALK DR",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065183706",
"telephone_number": "203-427-1624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 SUMMER ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069055359",
"telephone_number": "203-978-5775"
}
],
"practiceLocations": [
{
"address_1": "3231 Town Walk Dr",
"address_purpose": "LOCATION",
"city": "Hamden",
"state": "CT",
"postal_code": "065183706",
"country_code": "US",
"telephone_number": "203-427-1624",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENTZEN",
"first_name": "ELIZABETH",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CT",
"license": "501",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "143279",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.