Organization Active NPI

Jeffrey H Gimbel MD LLC

  • Internal Medicine Physician
  • Wallingford, CT
National Provider Identifier
1811219801
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
037053 Issued in CT
Legal business name
JEFFREY H GIMBEL MD LLC
Practice address
50 S Main St
Wallingford, CT 06492-4219
Phone
(203) 269-9400
Fax
(203) 269-9455
NPI assigned
Feb 18, 2010
Last updated
Oct 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Dr. Jeffrey H Gimbel, M.D.NPI 1861436735
Title
President
Phone
(203) 269-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 037053 CT Primary

Addresses

Primary practice location

50 S Main St
Wallingford, CT 06492-4219

Mailing address

PO Box 864
Wallingford, CT 06492-0864
Phone (203) 269-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100915000386 CT Part B Supplier - Clinic/Group Practice 3971628819 Receives reassigned benefits from 1 practitioner
Practice locations: North Haven, CT

National Provider Directory

National Provider Directory

Locations

3 Lincoln St
North Haven, CT 06473
Phone (203) 269-9400

50 S Main St
Wallingford, CT 06492
Phone (203) 269-9400

50 S Main St
Ste 3A
Wallingford, CT 06492

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDHAAA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1811219801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064920864",
            "telephone_number": "203-269-9400",
            "fax_number": "203-269-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MAIN ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924219",
            "telephone_number": "203-269-9400",
            "fax_number": "203-269-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY H GIMBEL MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "GIMBEL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-269-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "037053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.