Individual provider Active NPI

Jennifer M Nori, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Fairfield, CT
National Provider Identifier
1780607945
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001899 Issued in CT
Practice address
93 Nonopoge Rd
Fairfield, CT 06825-7219
Phone
(203) 260-6829
NPI assigned
Jul 26, 2006
Last updated
Jul 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA052261 PA
Surgical Physician Assistant 363AS0400X 001899 CT Primary

Addresses

Primary practice location

93 Nonopoge Rd
Fairfield, CT 06825-7219

Mailing address

75 Kings Hwy Cutoff
Fairfield, CT 06824
Phone (203) 337-2600

Other names 1

  • Miss Jennifer M Bisson Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070920000481 CT Practitioner - Physician Assistant 1557370053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001899CTMDClinical Psychologist
1899CTMDRegistered Dietitian
MA052261PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Nov 1, 2019 Accepting new patients
Yale University CurrentSince Nov 1, 2019 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: jnori4122@direct.ynhh.org

Organizations & group practices 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1780607945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 KINGS HWY CUTOFF",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824",
            "telephone_number": "203-337-2600",
            "fax_number": "203-337-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 NONOPOGE RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068257219",
            "telephone_number": "203-260-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORI",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA052261",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BISSON",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.