Individual provider Active NPI

Vanessa Sitara B Jacob, MD

  • Family Medicine Physician
  • Danielson, CT
National Provider Identifier
1922660844
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
69802 Issued in CT
Practice address
45 Green Hollow Rd
Danielson, CT 06239-3509
Phone
(860) 779-1865
NPI assigned
Jul 1, 2019
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 69802 CT Primary
Hospitalist Physician 208M00000X 69802 CT

Addresses

Primary practice location

45 Green Hollow Rd
Danielson, CT 06239-3509

Mailing address

320 Pomfret St
Putnam, CT 06260-1836

Other practice location 1

330 Pomfret St
Putnam, CT 06260-3803
Phone (860) 928-7704

Other practice location 2

320 Pomfret St
Putnam, CT 06260-1836
Phone (917) 399-9627

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722002415 CT Practitioner - Hospitalist 8426389412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69802CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Medical Group Inc Family Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225

45 Green Hollow Rd
Danielson, CT 06239
Phone (860) 774-1255

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

320 Pomfret St
#2
Putnam, CT 06260

330 Pomfret St
Putnam, CT 06260
Phone (860) 928-2736

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4
  • Direct secure messaging: vanessa.jacob.1@1694.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1922660844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-779-1865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062603803",
            "country_code": "US",
            "telephone_number": "860-928-7704",
            "fax_number": "860-928-4092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062601836",
            "country_code": "US",
            "telephone_number": "917-399-9627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "VANESSA SITARA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "69802",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "69802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.