Jenna Addison
Individual provider Active NPI Family Nurse Practitioner · Trumbull, CT
NPI 1649725656 · NPPES record last updated Jun 20, 2017
Key facts
- NPI
- 1649725656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 6670 (CT)
- Practice address
- 5520 Park Ave
Trumbull, CT 06611-3463 - Phone
- (203) 337-8790
- NPI assigned
- Aug 19, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yale University
Practice addresses (Care Compare)
20 York St
New Haven, CT 06510-3220
Phone (203) 688-2433
Hospital & facility affiliations
- Bridgeport Hospital
- Yale-New Haven Hospital
- Greenwich Hospital Association -
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161114001369 | CT | Practitioner - Nurse Practitioner | 7911286042 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102579 | CT | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients |
Locations
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
20 York St
North Haven, CT 06510
Phone (203) 688-2433
5520 Park Ave
Trumbull, CT 06611
Phone (203) 334-7400
Interoperability endpoints
- jaddison182099@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 102579 | CT | |
| Family Nurse Practitioner | 363LF0000X | 6670 | CT | Yes |
Addresses
Primary practice location
5520 Park Ave
Trumbull, CT 06611-3463
Mailing address
5520 Park Avenue
Trumbull, CT 06611
Other providers in Trumbull, CT
- A Big Life LLC
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- Roxanne C Abder
- Bassem Onsy Abraham
- Charlene Adams
- Adult & Pediatric Dermatology Specialists, P.C.
- Advanced Natural Therapeutics, LLC
- Aftercare Physical Therapy Services LLC
- Zara Ahmed
- Oluwatobi Taiwo Akangbe
All providers in Trumbull, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2017. 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.