Individual provider Active NPI

Bradley Jerson, PHD

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1720405715
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003501 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9507
Fax
(860) 545-9561
NPI assigned
Mar 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 003501 CT
Clinical Child & Adolescent Psychologist 103TC2200X 003501 CT
Clinical Psychologist 103TC0700X 003501 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

100 Retreat Ave
Hartford Hospital Child Psychiatry, Div of Psychology
Hartford, CT 06106-2528
Phone (860) 837-5206

Other practice location 1

100 Retreat Ave
Hartford Hospital Child Psychiatry, Div of Psychology
Hartford, CT 06106-2528
Phone (860) 837-5206

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bjerson18227@connecticutchildrens.direct-ci.com

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
I20151207000855 CT Practitioner - Clinical Psychologist 0244530731 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003501CTMDClinical Psychologist
3501CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Oct 5, 2015 Accepting new patients
Hartford Hospital CurrentSince Oct 5, 2015 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Connecticut Children'S Medical Center Past Accepting new patients

Locations

105 Newtown Rd
#A
Danbury, CT 06810
Phone (860) 545-9395

10 Birdseye Rd
Ste 110
Farmington, CT 06032
Phone (860) 231-8482

399 Farmington Ave
Farmington, CT 06032
Phone 2032372477222

310 Western Blvd
Glastonbury, CT 06033
Phone (860) 837-9877

282 Washington St
Ste 2K
Hartford, CT 06106
Phone (860) 545-9560

85 Seymour St
Ste 918
Hartford, CT 06106
Phone (860) 527-2566

100 Retreat Ave
Ste 5015
Hartford, CT 06106
Phone (860) 837-9700

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

100 Retreat Ave
Hartford, CT 06106
Phone (860) 244-0148

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

2 Ivy Brook Rd
Ste 213
Shelton, CT 06484
Phone (203) 538-5400

1281 E Main St
Ste 3
Stamford, CT 06902
Phone (860) 545-9200

191 Post Rd W
#1
Westport, CT 06880

Interoperability endpoints

  • Direct secure messaging: bjerson18227@connecticutchildrens.direct-ci.com

Organizations & group practices 5

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1720405715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "HARTFORD HOSPITAL CHILD PSYCHIATRY, DIV OF PSYCHOLOGY",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062528",
            "telephone_number": "860-837-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9507",
            "fax_number": "860-545-9561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Retreat Ave",
            "address_2": "Hartford Hospital Child Psychiatry, Div of Psychology",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061062528",
            "country_code": "US",
            "telephone_number": "860-837-5206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERSON",
        "first_name": "BRADLEY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003501",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "003501",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjerson18227@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.