Individual provider Active NPI

Jaclyn Gilgallon, APRN

  • Acute Care Nurse Practitioner
  • Meriden, CT
National Provider Identifier
1801318670
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
7087 Issued in CT
Practice address
435 Lewis Ave
Meriden, CT 06451-2101
Phone
(203) 694-8200
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 7087 CT Primary

Addresses

Primary practice location

435 Lewis Ave
Meriden, CT 06451-2101

Mailing address

53 Wilson Ave
Meriden, CT 06450-6915

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
I20170921003696 CT Practitioner - Nurse Practitioner 6002180502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Merit-based Incentive Payment System (MIPS)

Final score
97.06 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7087CTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 29, 2018 Accepting new patients
Midstate Medical Center CurrentSince Aug 15, 2017 Accepting new patients
Midstate Medical Center CurrentSince Aug 15, 2017 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 29, 2018 Accepting new patients
Midstate Medical Center Current Accepting new patients

Locations

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
#E119
New Britain, CT 06052

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

Interoperability endpoints

  • Direct secure messaging: jaclyn.gilgallon@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1801318670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WILSON AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "203-694-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILGALLON",
        "first_name": "JACLYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "7087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.