Jacqueline Ortiz-Skenderidis, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5364 Issued in CT

Practice address

12 N Main St Ste 110
West Hartford, CT 06107-1932

Phone

(860) 337-9800

Fax

(860) 263-7329

NPI assigned

Jul 2, 2013

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Josco Medical Group LLC

  • Nurse Practitioner
  • West Hartford, CT
  • NPI 1396314266
  Medicare reassignment NPD Authorized official
• Johnson Professional Associates, PC

  • Hospitalist Physician
  • Stafford Springs, CT
  • NPI 1770564262
  NPD (past)

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1720428949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST STE 110",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "860-337-9800",
            "fax_number": "860-263-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST STE 110",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "860-337-9800",
            "fax_number": "860-263-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ-SKENDERIDIS",
        "first_name": "JACQUELINE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005364",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optimal Wellness of West Hartford,LLC
• Optometric Specialty Group Limited Liability Company
• Natalia D Orosco, COTA/L
• Christopher Kin Ming Orr, M.D.
• Richard Steven Ortegon, MD
• Rachael Dawn Ortiz, M.S. LMFT
• Julia Osei-Tutu
• Katherine E Oshana, LPC, ATR
• Jillian Marie Ouellette, DC
• Audrey Kinnear Oweimrin, PA-C

• Family Nurse Practitioner in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.