Jay Allen Kimmel, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

031614 Issued in CT

Practice address

113 Elm St Ste 302
Enfield, CT 06082-3739

Phone

(203) 253-0276

NPI assigned

Oct 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1699765727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2126",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051719",
            "telephone_number": "860-253-0276",
            "fax_number": "860-547-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 ELM ST STE 302",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823739",
            "telephone_number": "203-253-0276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Asylum Ave",
            "address_2": "Suite 2126",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051770",
            "country_code": "US",
            "telephone_number": "860-728-6740",
            "fax_number": "860-547-1554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Jolley Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "CT",
            "postal_code": "060024228",
            "country_code": "US",
            "telephone_number": "860-253-0276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "031614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM / BCBS",
            "identifier": "010031614CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Enfield, CT
• Providers in Enfield, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.