Jennifer Anne Williams, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

002056 Issued in CT

Practice address

130 Division St
Derby, CT 06418-1326

Phone

(203) 732-1330

Fax

(203) 732-1332

NPI assigned

Jan 21, 2008

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

Other names 1

• Ms. Jennifer Donovan Former name

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

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Vascular Surgical Associates PCGroup PAC ID 9931102654, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilliams364047@direct.ynhh.org
• Direct secure messaging: jennifera.williams@xdr.hhchealthdirect.org

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.

• Connecticut Vascular Surgical Associates, PC

  • Vascular Surgery Physician
  • Shelton, CT
  • NPI 1801805403
  Medicare reassignment Care Compare group
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216

  Surgical

  Medicare reassignment NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Griffin Faculty Physicians, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Derby, CT
  • NPI 1598755605
  Medicare reassignment
• Neighborhood Health, Inc.

  • General Practice Physician
  • Torrington, CT
  • NPI 1043544489
  Medicare reassignment
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Mill Hill Medical Consultants Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • New Haven, CT
  • NPI 1891019675
  NPD

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1659557643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1256",
            "fax_number": "203-732-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "002056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DONOVAN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Edward Weiss, PA-C
• Emily Jean Wengertsman, MS, LPC
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• Dorothea Wild, M.D.
• Nicole Marie Wolf, PA-C
• Abigail Davis Wolff-France, LMFT
• Lihong Xia, MD
• Mark Yerushalmi
• Tiji Saji Zehring, PA

• Surgical Physician Assistant in Derby, CT
• Providers in Derby, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.