Jared Tannenbaum MD LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

JARED TANNENBAUM MD LLC

Practice address

50 Reserve Rd
Danbury, CT 06810-5182

Phone

(954) 648-1788

NPI assigned

Aug 21, 2025

Last updated

Sep 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jared Tannenbaum, MDNPI 1104288117

Title

Owner

Phone

(954) 648-1788

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jared Tannenbaum, MD

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1104288117

  CT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1396623195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1001",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068902001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 RESERVE RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105182",
            "telephone_number": "954-648-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARED TANNENBAUM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-648-1788",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evette Natasha James, APRN
• Susanmary Christin Janerico
• Janet G Cunningham (Inner Path to Wellness LLC)
• Anisha Advani Jangi, M.D.
• Lauren Jansky
• Brian Jaroniewski, DMD
• Edward Zachary Jaroszewski, PA-C
• Robert Marc Jarrett, MD
• Tabinda Jawaid
• Oghenevese Ibinabo Jefia, MD

• Physical Medicine & Rehabilitation Physician in Danbury, CT
• Providers in Danbury, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.