Individual provider Active NPI

John J James, MD

  • Sports Medicine (Emergency Medicine) Physician
  • Glastonbury, CT
National Provider Identifier
1881835510
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
051978 Issued in CT
Practice address
95 Glastonbury Blvd Ste 202
Glastonbury, CT 06033-4456
Phone
(959) 251-1770
NPI assigned
Mar 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA08745100 NJ
Emergency Medicine Physician 207P00000X 252115 NY
Sports Medicine (Emergency Medicine) Physician 207PS0010X 051978 CT Primary

Addresses

Primary practice location

95 Glastonbury Blvd Ste 202
Glastonbury, CT 06033-4456

Mailing address

55 Walls Dr Ste 405
Fairfield, CT 06824-5163
Phone (203) 409-8415

Other identifiers 1

IdentifierTypeStateIssuer
051978OtherCTCT MD LICENSE

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
I20141007001682 CT Practitioner - Sports MedicinePractitioner - Emergency Medicine 5991857351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Emergency Medicine
Education
State University of New York Downstate Medical Center, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVC CTGroup PAC ID 3274905104, 4 clinicians

Practice addresses (Care Compare)

40 Dale Rd
Suite 201
Avon, CT 06001-3692
Phone (866) 607-2308

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051978CTMDSports Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVC CT CurrentSince Jan 9, 2023 Accepting new patients
Saint Peter's Healthcare System Physician Associates Past Accepting new patients

Locations

40 Dale Rd
Ste 201
Avon, CT 06001
Phone (860) 676-9350

55 Walls Dr
Ste 405
Fairfield, CT 06824
Phone (203) 259-7070

95 Glastonbury Blvd
Ste 202
Glastonbury, CT 06033
Phone (860) 365-2840

1952 Whitney Ave
Ste 302
Hamden, CT 06517

2001 W Main St
Ste 225
Stamford, CT 06902

1389 W Main St
Ste 102
Waterbury, CT 06708

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1881835510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WALLS DR STE 405",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245163",
            "telephone_number": "203-409-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 GLASTONBURY BLVD STE 202",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334456",
            "telephone_number": "959-251-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA08745100",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "252115",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "CT",
            "license": "051978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MD LICENSE",
            "identifier": "051978",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.