Individual provider Active NPI

Jason N Dacruz, PA

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1417034786
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001947 Issued in CT
Practice address
85 Seymour St
Suite 607
Hartford, CT 06106-5501
Phone
(860) 549-3210
Fax
(860) 247-3803
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001947 CT Primary
Medical Physician Assistant 363AM0700X CT

Addresses

Primary practice location

85 Seymour St
Suite 607
Hartford, CT 06106-5501

Mailing address

270 Farmington Ave
Suite 102
Farmington, CT 06032-1909
Phone (860) 549-8276

Other identifiers 1

IdentifierTypeStateIssuer
003019478MedicaidCT

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
I20071214000471 CT Practitioner - Physician Assistant 6608874995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Associates of Hartford,PCGroup PAC ID 1850382409, 95 clinicians

Practice addresses (Care Compare)

150 Enterprise Dr
Rocky Hill, CT 06067-3579
Phone (860) 549-8276

201 N Mountain Rd
Suite 302
Plainville, CT 06062-1848
Phone (860) 612-6800

31 Seymour St
Suite 100
Hartford, CT 06106-5521
Phone (860) 549-3210

345 Western Blvd
Glastonbury, CT 06033-4380
Phone (860) 549-3210

37 Main St
Hebron, CT 06248-1516

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035

Merit-based Incentive Payment System (MIPS)

Final score
94.04 of 100Reported as group
Quality
98.06
Promoting interoperability
100
Improvement activities
40
Cost
82.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001947CTMDProfessional Counselor
2161MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Jan 18, 2010 Accepting new patients
Orthopedic Associates of Hartford,PC CurrentSince Jun 23, 2008 Accepting new patients
Orthopedic Associates of Hartford,PC CurrentSince Jun 23, 2008 Accepting new patients
Orthopedic Associates of Hartford,PC Past Accepting new patients

Locations

270 Farmington Ave
Ste 102
Farmington, CT 06032

499 Farmington Ave
Ste 300
Farmington, CT 06032
Phone (860) 549-8986

345 Western Blvd
Glastonbury, CT 06033
Phone (860) 549-8288

31 Seymour St
Ste 100
Hartford, CT 06106
Phone (860) 549-8208

85 Seymour St
Ste 607
Hartford, CT 06106
Phone 8605493210 ext. 8979

150 Enterprise Dr
Rocky Hill, CT 06067
Phone (860) 244-8857

Interoperability endpoints

  • Direct secure messaging: jason.dacruz@xdr.hhchealthdirect.org

Organizations & group practices 6

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 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1417034786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "SUITE 102",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-549-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 607",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-549-3210",
            "fax_number": "860-247-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACRUZ",
        "first_name": "JASON",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001947",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003019478",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.