Active NPI
Jennifer L Zajac, D.O.
- Child & Adolescent Psychiatry Physician
- Hartford, CT
National Provider Identifier
1396057782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 52528
- Practice address
- 200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309 - Phone
- (860) 545-7203
- NPI assigned
- Jul 14, 2010
- Last updated
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 052528 | CT | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 52528 | CT | Primary |
Addresses
Primary practice location
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Mailing address
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone (860) 545-7203
Other practice location 1
282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008048069 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jzajac13654@direct.connecticutchildrens.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052528 | CT | MD | Psychiatry Physician |
| 52528 | CT | MD | Child & Adolescent Psychiatry Physician |
Interoperability endpoints
- jennifer.zajac@xdr.hhchealthdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1396057782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 RETREAT AVENUE",
"address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063309",
"telephone_number": "860-545-7203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 RETREAT AVENUE",
"address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063309",
"telephone_number": "860-545-7203"
}
],
"practiceLocations": [
{
"address_1": "282 Washington St",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061063322",
"country_code": "US",
"telephone_number": "860-545-9200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZAJAC",
"first_name": "JENNIFER",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-14",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "052528",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CT",
"license": "52528",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008048069",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jzajac13654@direct.connecticutchildrens.org",
"affiliation": "N",
"address_1": "282 Washington St",
"city": "Hartford",
"state": "CT",
"country_code": "US",
"postal_code": "061063322",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.