NPIMap

Individual provider Active NPI

Robert Nelson Jones, MD

  • Family Medicine Physician
  • Old Saybrook, CT
National Provider Identifier
1659513315
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
051171 Issued in CT
Practice address
154 Main St
Old Saybrook, CT 06475-2373
Phone
(860) 395-1212
Fax
(860) 358-8654
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 051171 CT Primary

Addresses

Primary practice location

154 Main St
Old Saybrook, CT 06475-2373

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-4820

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811005415 CT Practitioner - Family Practice 3577700210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

4 A Devine St
North Haven, CT 06473-2142
Phone (203) 281-5030

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 688-4242

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274801NYMDReligious Nonmedical Nursing Personnel

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Aug 15, 2022 Accepting new patients

Locations

4 Devine St
#A
North Haven, CT 06473
Phone (203) 287-6900

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: rjones373431@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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1659513315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4820",
            "fax_number": "860-358-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752373",
            "telephone_number": "860-395-1212",
            "fax_number": "860-358-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ROBERT",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "051171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.