Jurgen Ludwig Holleck, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

040023 Issued in CT

Practice address

950 Campbell Ave
Vact Healthcare
West Haven, CT 06516

Phone

(203) 932-5711

NPI assigned

Mar 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1811964257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "VACT HEALTHCARE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLECK",
        "first_name": "JURGEN",
        "middle_name": "LUDWIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001400233",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pochu Ho, MD
• Jennifer Hoey
• Tara Hoffman
• William Hoffman, PA
• Marie A Hofman, PHARMD
• Natasha Holley, MSW
• Natalie Frances Holt, M.D., M.P.H.
• Casandra Ann Holveck, PHARMD
• Jonathan Francis Hryb, D.C.
• John Schley Hughes, MD

• Internal Medicine Physician in West Haven, CT
• Providers in West Haven, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.

Verify at the official NPI Registry.