Active NPI
Jessica Fennell
- Pediatric Rheumatology Physician
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rheumatology Physician
- License
- 70529
- Practice address
- 282 Washington St
Hartford, CT 06106-3322 - Phone
- (860) 545-9970
- NPI assigned
- Apr 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 70529 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 107775809 | CT | |
| Pediatric Rheumatology Physician | 2080P0216X | 70529 | CT | Primary |
Addresses
Primary practice location
282 Washington St
Hartford, CT 06106-3322
Mailing address
535 E 70TH St
New York, NY 10021-4823
Phone (917) 260-3909
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FH_IR/R4/ | Direct | |
| Direct Messaging Address | jfennel106607@direct.HSS.edu | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Direct | |
| Direct Messaging Address | jfennell15433@direct.connecticutchildrens.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70529 | CT | MD | Pediatrics Physician |
| 107775809 | CT | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut Children's Specialty Group, Inc. | Pediatrics | Current | Accepting new patients |
| Connecticut Children's Specialty Group, Inc. | Pediatrics | Current | 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
Fl 1
Farmington, CT 06032
10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619
191 Post Rd W
#1
Westport, CT 06880
Interoperability endpoints
- jfennel106607@direct.hss.edu
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Hartford, CT
- NPI 1669448882
-
- Ophthalmology Physician
- Glastonbury, CT
- NPI 1568056984
Pediatrics
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hartford, CT
- NPI 1578106951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734998400000",
"number": "1790148914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214823",
"telephone_number": "917-260-3909",
"fax_number": "917-260-4522"
},
{
"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": "860-545-9970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNELL",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-04",
"last_updated": "2024-12-24",
"certification_date": "2024-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "70529",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "107775809",
"primary": false
},
{
"code": "2080P0216X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Rheumatology",
"state": "CT",
"license": "70529",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FH_IR/R4/",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfennel106607@direct.HSS.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "535 E 70th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100214823",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfennell15433@direct.connecticutchildrens.org",
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.