Individual provider Active NPI

Jennifer Taylor, M.D.

  • Cardiovascular Disease Physician
  • Derby, CT
National Provider Identifier
1700148962
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
54461 Issued in CT
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-1257
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 304193 LA
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 54461 CT Primary

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1256

Other identifiers 2

IdentifierTypeStateIssuer
02673751MedicaidMS
2435264MedicaidLA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013000271 CT Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9537488531 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

1591 Boston Post Rd
Suite 200
Guilford, CT 06437-4335
Phone (203) 867-5300

1952 Whitney Ave
Hamden, CT 06517-1209
Phone (203) 867-5300

251 W Main St
Suite 6
Branford, CT 06405-4047
Phone (203) 867-5300

46 Prince St
Suite 310
New Haven, CT 06519-1600
Phone (203) 867-5300

462 Queen St
Southington, CT 06489-1801

81 Meriden Ave
Southington, CT 06489-3268
Phone (860) 276-5000

863 N Main St Ext
Suite 101
Wallingford, CT 06492-2434
Phone (203) 269-3791

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 5, 2024 Accepting new patients
Hartford Hospital CurrentSince Dec 5, 2024 Accepting new patients
Hartford Hospital CurrentSince Dec 5, 2024 Accepting new patients
Midstate Medical Center CurrentSince Dec 5, 2024 Accepting new patients
Midstate Medical Center CurrentSince Dec 5, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Cardiovascular Disease CurrentSince Dec 5, 2024 Accepting new patients
Midstate Medical Center Current Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Cardiovascular Disease CurrentSince Dec 5, 2024 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Dec 5, 2024 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

251 W Main St
Ste 6
Branford, CT 06405
Phone (203) 315-5300

130 Division St
Derby, CT 06418
Phone (203) 732-1330

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

863 N Main Street Ext
Ste 101
Wallingford, CT 06492
Phone (203) 269-3791

Organizations & group practices 11

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 6

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1700148962",
    "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"
        },
        {
            "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": "203-732-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "304193",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "54461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02673751",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2435264",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.