NPIMap

Individual provider Active NPI

Jon C Driscoll, M.D.

  • Orthopaedic Surgery Physician
  • Wallingford, CT
National Provider Identifier
1386667574
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
039464 Issued in CT
Practice address
863 N Main Street Ext
Suite 200
Wallingford, CT 06492-2434
Phone
(203) 265-3280
Fax
(203) 741-6575
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 039464 CT Primary

Addresses

Primary practice location

863 N Main Street Ext
Suite 200
Wallingford, CT 06492-2434

Mailing address

863 N Main Street Ext
Suite 200
Wallingford, CT 06492-2434
Phone (203) 265-3280

Other identifiers 1

IdentifierTypeStateIssuer
001394642MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000723 CT Practitioner - Orthopedic Surgery 6608992458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Yale University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Orthopedics and Musculoskeletal Care LLCGroup PAC ID 9830097864, 27 clinicians

Practice addresses (Care Compare)

863 N Main St Ext
Suite 200 FL 2
Wallingford, CT 06492-2434
Phone (203) 265-3280

Hospital & facility affiliations

  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Gaylord Hospital Inc Long-term care hospital, Wallingford, CT, CCN 072003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039464CTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Orthopedics & Musculoskeletal Care LLC Orthopaedic Surgery CurrentSince Sep 1, 2001 Accepting new patients
Comprehensive Orthopedics & Musculoskeletal Care LLC Orthopaedic Surgery PastSince Aug 13, 2023 Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

714 S Main St
Cheshire, CT 06410
Phone (203) 271-0556

455 Lewis Ave
Ste 101
Meriden, CT 06451
Phone (203) 639-7992

455 Lewis Ave
Ste 200
Meriden, CT 06451
Phone (203) 238-9446

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

98 Main St
Rear 1
Southington, CT 06489

601 N Main St
Southington, CT 06489

98 Main St
Ste 201
Southington, CT 06489
Phone (860) 329-0115

863 N Main Street Ext
Ste 200
Wallingford, CT 06492
Phone (203) 741-6547

Interoperability endpoints

  • Direct secure messaging: jdriscoll21377@xdr.hhchealthdirect.org

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.

Hospital & facility affiliations 8

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1386667574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT",
            "address_2": "SUITE 200",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-265-3280",
            "fax_number": "203-741-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT",
            "address_2": "SUITE 200",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-265-3280",
            "fax_number": "203-741-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "JON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "039464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001394642",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.