Individual provider Active NPI

Jarrod Poirier

  • Medical Physician Assistant
  • North Stonington, CT
National Provider Identifier
1639558497
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
391 Norwich Westerly Rd
North Stonington, CT 06359-9992
Phone
(860) 535-4600
NPI assigned
May 27, 2015
Last updated
May 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2015

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 CT Primary

Addresses

Primary practice location

391 Norwich Westerly Rd
North Stonington, CT 06359-9992

Mailing address

8 Standish Rd
Norfolk, MA 02056-1402
Phone (508) 528-2054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190701001026 NY Practitioner - Physician Assistant 2163724857 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3337MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 12, 2019 Accepting new patients
New York University CurrentSince Jun 12, 2019 Accepting new patients
Country Doc Walk-in &Wellness LLC Past Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jpoirier3520448@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1639558497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 STANDISH RD",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561402",
            "telephone_number": "508-528-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 NORWICH WESTERLY RD",
            "city": "NORTH STONINGTON",
            "state": "CT",
            "postal_code": "063599992",
            "telephone_number": "860-535-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "JARROD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Stonington, CT

Sources for this page

Verify at the official NPI Registry.