Individual provider Active NPI

Rachel Jankovsky, PA

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1912540964
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
024404 Issued in NY
Practice address
10 Columbus Blvd
Hartford, CT 06106-1976
Phone
(860) 837-5619
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024404 NY Primary

Addresses

Primary practice location

10 Columbus Blvd
Hartford, CT 06106-1976

Mailing address

60 Orange Ter
West Haven, CT 06516-1514
Phone (203) 605-2665

Other practice location 1

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-1911

Other practice location 2

1200 Driving Park Ave
Newark, NY 14513-1090
Phone (315) 359-2120

Other practice location 3

1425 Portland Ave Bldg 3
Rochester, NY 14621-3095
Phone (585) 922-0866

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjankovsky69607@connecticutchildrens.direct-ci.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920003476 CT Practitioner - Physician Assistant 8921432105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024404NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Physician Assistant CurrentSince Sep 6, 2022 Accepting new patients
Rochester General Hospital PastSince Oct 1, 2019 Accepting new patients

Locations

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1912540964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 ORANGE TER",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161514",
            "telephone_number": "203-605-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 COLUMBUS BLVD",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061976",
            "telephone_number": "860-837-5619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Coulter Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Springs",
            "state": "NY",
            "postal_code": "144321122",
            "country_code": "US",
            "telephone_number": "315-462-1911",
            "fax_number": "316-462-2430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131090",
            "country_code": "US",
            "telephone_number": "315-359-2120",
            "fax_number": "315-359-2806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Portland Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213095",
            "country_code": "US",
            "telephone_number": "585-922-0866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANKOVSKY",
        "first_name": "RACHEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2022-11-15",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjankovsky69607@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "10 Columbus Blvd",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061061976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.