Individual provider Active NPI

Jerry A. Ferrentino, M.D.

  • Obstetrics & Gynecology Physician
  • Milford, CT
National Provider Identifier
1740384429
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
032161 Issued in CT
Practice address
140 Clark St
Apartment 2
Milford, CT 06460-8427
Phone
(203) 693-3777
Fax
(203) 693-3408
NPI assigned
Sep 12, 2006
Last updated
Mar 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 032161 CT Primary

Addresses

Primary practice location

140 Clark St
Apartment 2
Milford, CT 06460-8427

Mailing address

140 Clark St
Apartment 2
Milford, CT 06460-8427
Phone (203) 693-3777

Other identifiers 1

IdentifierTypeStateIssuer
001321611MedicaidCT

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
I20120203000374 CT Practitioner - Obstetrics/Gynecology 1557450236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032161CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Obstetrics & Gynecology CurrentSince Jan 1, 2022 Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1740384429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CLARK ST",
            "address_2": "APARTMENT 2",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064608427",
            "telephone_number": "203-693-3777",
            "fax_number": "203-693-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CLARK ST",
            "address_2": "APARTMENT 2",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064608427",
            "telephone_number": "203-693-3777",
            "fax_number": "203-693-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRENTINO",
        "first_name": "JERRY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "032161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001321611",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.