Individual provider Active NPI

Sohaib Jamil, M.D.

  • Gastroenterology Physician
  • Avon, CT
National Provider Identifier
1417215161
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
63813 Issued in CT
Practice address
44 Dale Rd
Avon, CT 06001
Phone
(860) 674-8830
NPI assigned
May 1, 2012
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 283990 NY
Gastroenterology Physician 207RG0100X 63813 CT Primary

Addresses

Primary practice location

44 Dale Rd
Avon, CT 06001

Mailing address

30 Jordan LN Ste 3
Wethersfield, CT 06109-1244
Phone (860) 263-0253

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjamil423353@direct.stfranciscare.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717002236 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 6709111453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare, PCGroup PAC ID 6709787930, 67 clinicians

Practice addresses (Care Compare)

44 Dale Rd
Avon, CT 06001-4315
Phone (860) 674-8830

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy64
Upper gastrointestinal (GI) endoscopy for acid reflux77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63813CTMDGastroenterology Physician
283990NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Gastroenterology CurrentSince Jul 1, 2019 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Jul 1, 2019 Accepting new patients
Saint Francis Gi Endoscopy L.L.C Current Accepting new patients
Connecticut Surgeons, LLC Past Accepting new patients
Ajt Urology LLC PastSince Mar 24, 2025 Accepting new patients

Locations

44 Dale Rd
Avon, CT 06001
Phone (860) 674-8830

44 Dale Rd
Ste 204
Avon, CT 06001
Phone (860) 674-8830

925 Sullivan Ave
Ste 1
South Windsor, CT 06074
Phone (860) 644-1521

1007 Farmington Ave
Ste 9
West Hartford, CT 06107
Phone (860) 586-7825

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

30 Jordan Ln
Ste 2
Wethersfield, CT 06109
Phone 8606748830 ext. 30253

30 Jordan Ln
Ste 3
Wethersfield, CT 06109
Phone (860) 263-0253

350 Silas Deane Hwy
Ste 102
Wethersfield, CT 06109
Phone (860) 529-8670

Interoperability endpoints

  • Direct secure messaging: sjamil2382741@direct.trinity-health.org
  • Direct secure messaging: sohaib.jamil.1@31712.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1417215161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN STE 3",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091244",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-674-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIL",
        "first_name": "SOHAIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "283990",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "63813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjamil423353@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "44 Dale Rd",
            "city": "Avon",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.