Individual provider Active NPI

Jody Lynn Zenkus, MSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1699093492
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009126 Issued in CT
Practice address
60 N Main St
Waterbury, CT 06702-1443
Phone
(203) 437-8896
NPI assigned
May 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 009126 CT Primary

Addresses

Primary practice location

60 N Main St
Waterbury, CT 06702-1443

Mailing address

60 N Main St
Waterbury, CT 06702-1443
Phone (203) 437-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180924001355 CT Practitioner - Clinical Social Worker 2062797673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

55 W Main St
410 Western Connecticut Mental Health N
Waterbury, CT 06702-5524
Phone (203) 805-6414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009126CTMDPhysical Therapist
9126CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 1, 2020 Accepting new patients
State of Connecticut CurrentSince Jan 1, 2020 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1699093492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021443",
            "telephone_number": "203-437-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021443",
            "telephone_number": "203-437-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENKUS",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.