Individual provider Active NPI

Jennifer H Grant, MD

  • Obstetrics & Gynecology Physician
  • Hartford, CT
National Provider Identifier
1811096670
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
040153 Issued in CT
Practice address
136 Retreat Ave
Hartford, CT 06106
Phone
(860) 547-0306
Fax
(860) 525-9782
NPI assigned
Sep 21, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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 040153 CT Primary

Addresses

Primary practice location

136 Retreat Ave
Hartford, CT 06106

Mailing address

136 Retreat Ave
Hartford, CT 06106
Phone (860) 525-9763

Other identifiers 1

IdentifierTypeStateIssuer
001401538MedicaidCT

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
I20091013000521 CT Practitioner - Obstetrics/Gynecology 6608912217 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Connecticut School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women's Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040153CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital Obstetrics & Gynecology CurrentSince Oct 31, 2010 Accepting new patients
Hartford Hospital CurrentSince Oct 31, 2010 Accepting new patients
Physicians for Women's Health LLC Obstetrics & Gynecology CurrentSince Jul 29, 2002 Accepting new patients
Hartford Hospital CurrentSince Oct 31, 2010 Accepting new patients

Locations

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

330 Western Blvd
Ste 102
Glastonbury, CT 06033
Phone (860) 547-0306

Interoperability endpoints

  • Direct secure messaging: jennifer.grant.1@10170.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1811096670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-525-9763",
            "fax_number": "860-525-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-547-0306",
            "fax_number": "860-525-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "040153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001401538",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.