Individual provider Active NPI

Jessica Sierra, PH.D

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1538486584
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003206 Issued in CT
Practice address
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3310
Phone
(860) 545-7940
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 003206 CT Primary

Addresses

Primary practice location

200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3310

Mailing address

200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone (860) 545-7940

Other identifiers 1

IdentifierTypeStateIssuer
008030264MedicaidCT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000442 CT Practitioner - Clinical Psychologist 9234261652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Connecticut School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

330 Western Blvd
Glastonbury, CT 06033-4383
Phone (860) 696-4380

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003026CTMDPhysician Assistant
003206CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Nov 15, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Nov 15, 2023 Accepting new patients
Hartford Hospital CurrentSince May 3, 2010 Accepting new patients
Hartford Hospital CurrentSince May 3, 2010 Accepting new patients

Locations

330 Western Blvd
Glastonbury, CT 06033
Phone (860) 524-4566

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: jessica.sierra@xdr.hhchealthdirect.org

Organizations & group practices 4

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547337600000",
    "number": "1538486584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVENUE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVENUE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063310",
            "telephone_number": "860-545-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "JESSICA",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2019-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030264",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.