Active NPI
Jennifer O Letitia, M.D.
- Plastic Surgery Physician
- Fairfield, CT
National Provider Identifier
1740608207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 034391
- Practice address
- 501 Kings Hwy E Ste 108
Fairfield, CT 06825-4870 - Phone
- (203) 371-0300
- Fax
- (203) 680-9242
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery of the Hand (Plastic Surgery) Physician | 2082S0105X | 034391 | CT | |
| Plastic Surgery Physician | 208200000X | 034391 | CT | Primary |
Addresses
Primary practice location
501 Kings Hwy E Ste 108
Fairfield, CT 06825-4870
Mailing address
1 Tulip LN
Westport, CT 06880-2734
Phone (203) 293-5618
Other practice location 1
1 Tulip Ln
Westport, CT 06880-2734
Phone (203) 293-5618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23085 | Other | CT | CSP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 8, 2020 through Nov 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034391 | CT | MD | Surgery of the Hand (Plastic Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1740608207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 TULIP LN",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068802734",
"telephone_number": "203-293-5618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 KINGS HWY E STE 108",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068254870",
"telephone_number": "203-371-0300",
"fax_number": "203-680-9242"
}
],
"practiceLocations": [
{
"address_1": "1 Tulip Ln",
"address_purpose": "LOCATION",
"city": "Westport",
"state": "CT",
"postal_code": "068802734",
"country_code": "US",
"telephone_number": "203-293-5618",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LETITIA",
"first_name": "JENNIFER",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-02",
"last_updated": "2023-03-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "2082S0105X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Surgery of the Hand",
"state": "CT",
"license": "034391",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CT",
"license": "034391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSP",
"identifier": "23085",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.