Jaimee A Benes Dettmer, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Bridgeport, CT
NPI 1609080431 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609080431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 045.45 (CT)
- Practice address
- 89 Hart St
Bridgeport, CT 06606-5048 - Phone
- (203) 579-2229
- Fax
- (203) 579-0404
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Physicians for Women'S Health, LLC
Practice addresses (Care Compare)
103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789
29 Hospital PLZ
Suite 400
Stamford, CT 06902-3602
Phone (203) 325-4321
Hospital & facility affiliations
- Stamford Hospital
- Greenwich Hospital Association -
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.08 of 100
- Quality
- 85.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.8
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 |
|---|---|---|---|---|
| I20070721000013 | CT | Practitioner - Obstetrics/Gynecology | 5496856353 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045.45 | CT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians for Women'S Health LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
Locations
22 Waterville Rd
Avon, CT 06001
Phone (860) 678-3461
89 Hart St
Bridgeport, CT 06606
Phone (203) 579-2229
103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789
29 Hospital Plz
Ste 400
Stamford, CT 06902
Phone (203) 325-4321
Interoperability endpoints
- jbenesdettmer24669@stamfordhealth.direct-ci.com
- jaimee.benes-dettmer.2@10170.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 045.45 | CT | Yes |
Addresses
Primary practice location
89 Hart St
Bridgeport, CT 06606-5048
Mailing address
89 Hart St
Bridgeport, CT 06606-5048
Phone (203) 579-2229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045345 | Other | CT | LICENSE |
Other providers in Bridgeport, CT
- Matthew A Bellard
- Steven Lewis Belmont
- Glenn John Buenviaje Beloso
- Jailawu Ben
- Holly A Benedetto
- Elvina Benjamin
- Marissa Benvenuto
- James Patrick Berg
- Deborah Berger
- Ashlyn Berich
All providers in Bridgeport, CT · Obstetrics & Gynecology 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 Jul 8, 2007. 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.