Individual provider Active NPI

Miriam Susan Cohen, M.D.

  • Pediatrics Physician
  • Wallingford, CT
National Provider Identifier
1477517548
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
040590 Issued in CT
Practice address
97 Barnes Rd
Ste 6
Wallingford, CT 06492-1885
Phone
(203) 753-6776
Fax
(203) 573-1875
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 040590 CT Primary

Addresses

Primary practice location

97 Barnes Rd
Ste 6
Wallingford, CT 06492-1885

Mailing address

195 Bear Path Rd
Hamden, CT 06514-1342
Phone (203) 407-0161

Other identifiers 1

IdentifierTypeStateIssuer
001405902MedicaidCT

Other names 1

  • Dr. Miriam Susan Jennings Other name

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
I20040602000758 CT Practitioner - Pediatric Medicine 3577545763 Reassigns benefits to 1 organization
Practice locations: Waterbury, CT

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040590CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics Current Accepting new patients
Yale University CurrentSince Dec 19, 2023 Accepting new patients
Yale University CurrentSince Dec 19, 2023 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Park St
North Haven, CT 06504
Phone (203) 785-4643

Interoperability endpoints

  • Direct secure messaging: mcohen@direct.wtbyhosp.org
  • Direct secure messaging: mcohen2814@direct.ynhh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477517548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 BEAR PATH RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141342",
            "telephone_number": "203-407-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 BARNES RD",
            "address_2": "STE 6",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921885",
            "telephone_number": "203-753-6776",
            "fax_number": "203-573-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MIRIAM",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "040590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001405902",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "JENNINGS",
            "middle_name": "SUSAN",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.