Individual provider Active NPI

Jing Marrero

  • Pediatric Gastroenterology Physician
  • Hartford, CT
National Provider Identifier
1568968261
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
68064 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9000
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 68064 CT
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Gastroenterology Physician 2080P0206X 68064 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2147

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
I20240125003474 CT Practitioner - Pediatric Medicine 1153671631 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68064CTMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jan 15, 2024 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jan 15, 2024 Accepting new patients
Connecticut Children'S Medical Center Past Accepting new patients

Locations

105 Newtown Rd
#A
Danbury, CT 06810
Phone (860) 545-9395

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

310 Western Blvd
Glastonbury, CT 06033
Phone (860) 837-9877

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

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

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

191 Post Rd W
#1
Westport, CT 06880

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1568968261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "JING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "68064",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CT",
            "license": "68064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.