Jack Anthony Porrino Jr., M.D.
Individual provider Active NPI Diagnostic Radiology Physician · New Haven, CT
NPI 1487858833 · NPPES record last updated Aug 20, 2018
Key facts
- NPI
- 1487858833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 61071 (CT)
- Practice address
- 20 York St
New Haven, CT 06510 - Phone
- (203) 688-4242
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of Nevada School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yale University
Practice addresses (Care Compare)
20 York St
New Haven, CT 06510-3220
Phone (203) 688-2433
Hospital & facility affiliations
- Yale-New Haven Hospital
- Bridgeport Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180802000793 | CT | Practitioner - Diagnostic Radiology | 9133250277 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76659 | AZ | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Specialty Group, P.C. | Diagnostic Radiology | Current |
Accepting new patients |
| Yale University | Diagnostic Radiology | Current |
Accepting new patients |
| Orthopaedic Specialty Group, P.C. | Diagnostic Radiology | Current |
Accepting new patients |
| Yale University | Current |
Accepting new patients | |
| Arizona Oncology Associates PC | Diagnostic Radiology | Past | Accepting new patients |
| Arizona State Radiology, PC | Diagnostic Radiology | Past |
Accepting new patients |
Locations
305 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 337-2600
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
20 York St
North Haven, CT 06510
Phone (203) 688-2433
Interoperability endpoints
- jporrino402965@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD60135255 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | 76659 | AZ | |
| Diagnostic Radiology Physician | 2085R0202X | 61071 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510
Mailing address
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487858833 | Medicaid | WA |
Other providers in New Haven, CT
- Victoria Popielarz
- Veljko Mileta Popov
- Ben S. Popple
- Rozlyn Grace Poray
- Carol Susan Porrello
- Zachary Port
- George Arthur Porter Jr.
- Gerald Portman
- James Porzio
- Positive Services for Kids, LLC
All providers in New Haven, CT · Diagnostic Radiology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.