Individual provider Active NPI

Jason Pelham Lott, M.D., M.S.H.P. M.H.S

  • Dermatology Physician
  • New Haven, CT
National Provider Identifier
1639303373
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
051084 Issued in CT
Practice address
428 Columbus Ave
New Haven, CT 06519-1233
Phone
(203) 503-3000
NPI assigned
May 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT194913 PA
Student in an Organized Health Care Education/Training Program 390200000X MT194913 PA
Dermatology Physician 207N00000X 051084 CT Primary

Addresses

Primary practice location

428 Columbus Ave
New Haven, CT 06519-1233

Mailing address

428 Columbus Ave
P.O. Box 208059
New Haven, CT 06519-1233
Phone (203) 503-3000

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
I20151204002034 CT Practitioner - Dermatology 9739489287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornell Scott Hill Health CorporationGroup PAC ID 3072418359, 261 clinicians

Practice addresses (Care Compare)

428 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051084CTMDDermatology Physician
MT194913PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince Oct 17, 2015 Accepting new patients

Locations

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

Interoperability endpoints

  • Direct secure messaging: jlott3833@direct.ynhh.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": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1639303373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 COLUMBUS AVE",
            "address_2": "P.O. BOX 208059",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTT",
        "first_name": "JASON",
        "middle_name": "PELHAM",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.H.P. M.H.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT194913",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT194913",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "051084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.