Individual provider Active NPI

Jacinta Renaldi, NP

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1366690380
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
003856 Issued in CT
Practice address
3203 Main St
Bridgeport, CT 06606-4225
Phone
(203) 371-0009
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 003856 CT Primary

Addresses

Primary practice location

3203 Main St
Bridgeport, CT 06606-4225

Mailing address

3203 Main St
Bridgeport, CT 06606-4225
Phone (203) 371-0009

Other names 1

  • Jacinta Pereira 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
I20081219000385 CT Practitioner - Nurse Practitioner 0042372302 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
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

330 Orchard St
New Haven, CT 06511-4417
Phone (203) 680-7050

6 Devine St
North Haven, CT 06473-2195
Phone (203) 287-6100

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

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3856CTMDMental Health Counselor
003856CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Current Accepting new patients
Joao Nascimento MD LLC CurrentSince Jan 8, 2013 Accepting new patients
Yale University CurrentSince Jan 6, 2015 Accepting new patients
Yale University CurrentSince Jan 6, 2015 Accepting new patients

Locations

3203 Main St
Bridgeport, CT 06606
Phone (203) 371-0009

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

Interoperability endpoints

  • Direct secure messaging: jrenaldi182976@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 and National Provider Directory roles.

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1366690380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064225",
            "telephone_number": "203-371-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064225",
            "telephone_number": "203-371-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENALDI",
        "first_name": "JACINTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINTA",
            "last_name": "PEREIRA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.