Individual provider Active NPI

Johan Van Jaarsveld

  • Pulmonary Disease Physician
  • Woodbridge, CT
National Provider Identifier
1396024980
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
051848 Issued in CT
Practice address
81 Deer Run Rd
Woodbridge, CT 06525-1907
Phone
(281) 460-9533
NPI assigned
Aug 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 051848 CT Primary

Addresses

Primary practice location

81 Deer Run Rd
Woodbridge, CT 06525-1907

Mailing address

81 Deer Run Rd
Woodbridge, CT 06525-1907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108002644 TN Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 0042470189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Critical Care (Intensivists), Internal Medicine, Pulmonary Disease
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Practice addresses (Care Compare)

1156 Nashville Pike
Gallatin, TN 37066-3110
Phone (615) 989-1088

Hospital & facility affiliations

  • Tristar Southern Hills Medical Center Hospital, Nashville, TN, CCN 440197

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051848CTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anova Medical Associates, PLC CurrentSince Aug 22, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1156 Nashville Pike
Gallatin, TN 37066
Phone (615) 989-1088

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 1

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1396024980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 DEER RUN RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 DEER RUN RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251907",
            "telephone_number": "281-460-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN JAARSVELD",
        "first_name": "JOHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "051848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

Verify at the official NPI Registry.