Individual provider Active NPI

Jennifer M Wilcox, NP

  • Primary Care Nurse Practitioner
  • Berlin, CT
National Provider Identifier
1386280121
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
8586 Issued in CT
Practice address
175 Webster Square Rd
Berlin, CT 06037-2328
Phone
(860) 420-3660
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 8586 CT Primary

Addresses

Primary practice location

175 Webster Square Rd
Berlin, CT 06037-2328

Mailing address

26 Maple St
Rockfall, CT 06481-2026
Phone (860) 344-1516

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
I20200206000238 CT Practitioner - Nurse Practitioner 1951737105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

339 W Main St
Avon, CT 06001-4322
Phone (860) 524-3058

85 Seymour St
Hartford, CT 06106-5501
Phone (860) 545-5107

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8586CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Apr 1, 2020 Accepting new patients
Hartford Hospital CurrentSince Apr 1, 2020 Accepting new patients
Hartford Hospital CurrentSince Apr 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

339 W Main St
Avon, CT 06001
Phone (860) 696-2150

175 Webster Square Rd
Berlin, CT 06037
Phone (860) 200-8095

330 Western Blvd
Glastonbury, CT 06033
Phone (860) 524-4566

85 Seymour St
Hartford, CT 06106
Phone (860) 246-4029

205 Sub Way
Ste 200
Milford, CT 06461

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

65 Memorial Rd
West Hartford, CT 06107
Phone (860) 231-1707

Interoperability endpoints

  • Direct secure messaging: jennifer.wilcox@xdr.hhchealthdirect.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 5

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1386280121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MAPLE ST",
            "city": "ROCKFALL",
            "state": "CT",
            "postal_code": "064812026",
            "telephone_number": "860-344-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WEBSTER SQUARE RD",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372328",
            "telephone_number": "860-420-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "8586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

Sources for this page

Verify at the official NPI Registry.