Individual provider Active NPI

Jennifer Wu

  • Diagnostic Radiology Physician
  • New Haven, CT
National Provider Identifier
1912389008
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2970 Issued in NH
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 264427 MA
Diagnostic Radiology Physician 2085R0202X 68778 CT
Diagnostic Radiology Physician 2085R0202X 2970 NH Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220317001965 MA Practitioner - Diagnostic Radiology 2769773639 Reassigns benefits to 1 organization
I20220318000767 CT Practitioner - Diagnostic Radiology 2769773639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology and Imaging IncGroup PAC ID 9234110479, 58 clinicians

Practice addresses (Care Compare)

113 Elm St
Suite 206
Enfield, CT 06082-3738
Phone (860) 741-2177

115 W Silver St
Westfield, MA 01085-3678
Phone (413) 568-2811

164 High St
Greenfield, MA 01301-2613
Phone (413) 773-2674

325 B King St
Northampton, MA 01060-2370
Phone (413) 387-4100

40 Wright St
Palmer, MA 01069-1138
Phone (413) 284-5241

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 827-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68778CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin MRI Center LLC CurrentSince Apr 6, 2022 Accepting new patients
Franklin MRI Center LLC CurrentSince Apr 13, 2002 Accepting new patients
Baystate MRI & Imaging Center, LLC CurrentSince Apr 6, 2022 Accepting new patients
Radiology & Imaging, Inc. Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients

Locations

113 Elm St
Ste 206
Enfield, CT 06082
Phone (860) 741-2177

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1912389008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "264427",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "68778",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "2970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.