Jerezem Sison Fegley, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10250 Issued in CT

Practice address

950 Campbell Ave
West Haven, CT 06516-2770

Phone

(203) 932-5711

NPI assigned

Mar 17, 2020

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Derby, CT
  • NPI 1598755605
  NPD

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1700412111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "860-666-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Seymour Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064181343",
            "country_code": "US",
            "telephone_number": "203-732-2651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Willard Ave",
            "address_purpose": "LOCATION",
            "city": "Newington",
            "state": "CT",
            "postal_code": "061112631",
            "country_code": "US",
            "telephone_number": "860-666-6951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Foote Ave",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "NY",
            "postal_code": "147016947",
            "country_code": "US",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEGLEY",
        "first_name": "JEREZEM",
        "middle_name": "SISON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2022-10-04",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "10250",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Jean Farley, MSW, LCSW
• Catherine Heffernan Farrell, LCSW
• Maryelizabeth Farrell, MA., LPC.
• Fast Rehabilitation Services
• Daniel Glenn Federman, M.D.
• Richard Barry Feldman, D.P.M.
• Elizabeth Felix, RN
• Andy Daniel Fernandez, PHARMD
• Susan V. Fernandez, DO
• Benedict Fernando, M.D.

• Nurse Practitioner in West Haven, CT
• Providers in West Haven, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.