Josco Medical Group LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

JOSCO MEDICAL GROUP LLC

Practice address

12 N Main St Ste 110
West Hartford, CT 06107-1932

Phone

(860) 337-9800

Fax

(860) 263-7329

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Jacqueline Ortiz-SkenderidisNPI 1720428949

Title

Owner

Phone

(860) 337-9800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Ortiz-Skenderidis, APRN

  • Family Nurse Practitioner
  • West Hartford, CT
  • NPI 1720428949
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1396314266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NORTH MAIN STREET, SUITE 110",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "608-337-9800",
            "fax_number": "860-263-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST STE 110",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "860-337-9800",
            "fax_number": "860-263-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSCO MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-SKENDERIDIS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-337-9800"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daniel Jones, PH.D.
• Karen Meredith Jones, MD
• Melissa Jones I
• Rene F Jones
• Joseph Family Markets LLC
• Raven Joseph
• Swanel R Joseph
• Gyanendra Raj Joshi, PHARMD
• Sowmya Josyula, M.D., MPH

• Nurse Practitioner in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.