Individual provider Active NPI

James Robert Gerace, PA

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1508887936
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001146 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1221
Phone
(203) 709-3538
Fax
(203) 709-7258
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001146 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1221

Mailing address

56 Franklin St
3Rd Floor
Waterbury, CT 06706-1221
Phone (203) 709-8873

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-8950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgerace6444@connecticutchildrens.direct-ci.com

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
I20090331000460 CT Practitioner - Physician Assistant 9830256163 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001146CTMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. CurrentSince May 15, 2023 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

263 Farmington Ave
Farmington, CT 06032
Phone (860) 679-1706

80 Seymour St
Fl 5
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

282 Washington St
Ste 2B
Hartford, CT 06106
Phone (860) 545-9216

100 Retreat Ave
Fl 5
Hartford, CT 06106
Phone (860) 837-5206

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

Interoperability endpoints

  • Direct secure messaging: jgerace6444@connecticutchildrens.direct-ci.com
  • Direct secure messaging: jgerace2433994@direct.trinity-health.org

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1508887936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "address_2": "3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-8873",
            "fax_number": "203-709-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-3538",
            "fax_number": "203-709-7258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-8950",
            "fax_number": "860-545-8959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERACE",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgerace6444@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.