Individual provider Active NPI

Justine Lauren Vanacore, PA-C

  • Physician Assistant
  • Middletown, CT
National Provider Identifier
1407101819
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015773 Issued in NY
Practice address
410 Saybrook Rd Ste 100
Middletown, CT 06457-4780
Phone
(860) 685-8940
NPI assigned
Jul 23, 2012
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015773 NY Primary

Addresses

Primary practice location

410 Saybrook Rd Ste 100
Middletown, CT 06457-4780

Mailing address

410 Saybrook Rd Ste 100
Middletown, CT 06457-4780
Phone (860) 685-8940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170324000366 CT Practitioner - Physician Assistant 8628368685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

117 Main St
Hebron, CT 06248-1519
Phone (860) 264-1940

14 Jones Hollow Rd
Suite 2
Marlborough, CT 06447-1448
Phone (860) 358-2850

512 Saybrook Rd
Suite 100
Middletown, CT 06457-4788
Phone (860) 347-7636

52 Spencer Plain Rd
Old Saybrook, CT 06475-4000
Phone (860) 347-7636

540 Saybrook Rd
Middletown, CT 06457-4711
Phone (860) 358-5120

6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.55
Promoting interoperability
100
Improvement activities
40
Cost
64.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
051773NYMDPeriodontist
015773NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Dec 1, 2021 Accepting new patients
MHS Primary Care, Inc Physician Assistant CurrentSince Jul 31, 2020 Accepting new patients
MHS Primary Care Inc Physician Assistant CurrentSince Jul 31, 2020 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC Physician Assistant CurrentSince Dec 1, 2021 Accepting new patients

Locations

6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145

117 Main St
Hebron, CT 06248
Phone (860) 228-3888

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

410 Saybrook Rd
Ste 100
Middletown, CT 06457
Phone (860) 685-8951

512 Saybrook Rd
Ste 100
Middletown, CT 06457
Phone (860) 704-6021

430 Saybrook Rd
Middletown, CT 06457
Phone (860) 638-3820

510 Saybrook Rd
Middletown, CT 06457
Phone (860) 346-2267

540 Saybrook Rd
Ste 100B
Middletown, CT 06457
Phone (860) 347-6683

505 Willard Ave
Ste C
Newington, CT 06111
Phone (860) 223-8553

4 Grove Beach Rd N
Ste E
Westbrook, CT 06498

Interoperability endpoints

  • Direct secure messaging: jvanacore@ons.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1407101819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-685-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-685-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANACORE",
        "first_name": "JUSTINE",
        "middle_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.