Heba Hussam El-Jafarawi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4972 Issued in CT

Practice address

179 Talcottville Rd
Vernon Rockville, CT 06066-4615

Phone

(860) 986-7600

NPI assigned

Sep 10, 2020

Last updated

Sep 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northeastern Pulmonary Associates LLC

  • Pulmonary Disease Physician
  • Vernon, CT
  • NPI 1730134305
  Medicare reassignment

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1649885138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AMBASSADOR DR UNIT A",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422456",
            "telephone_number": "860-729-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 TALCOTTVILLE RD",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060664615",
            "telephone_number": "860-986-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-JAFARAWI",
        "first_name": "HEBA",
        "middle_name": "HUSSAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Neuhaus, MD
• Susan Davis, RPH
• Sandy De Leon Adames
• Dental Associates of Rockville LLC
• Dr. Girish Sharma
• Emily Wyckoff LLC
• Exchange Club Center for the Prevention of Child Abuse of CT, Inc. (Kidsafe CT)
• Nidhi Faldu
• Lydia Gilkes
• Michael Neil Goldman, CPHT

• Physician Assistant in Vernon Rockville, CT
• Providers in Vernon Rockville, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.