Individual provider Active NPI

Jaimee Taylor Dizenzo

  • Family Nurse Practitioner
  • Southington, CT
National Provider Identifier
1942983960
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12251 Issued in CT
Practice address
249 Spring Lake Rd
Southington, CT 06489-4426
Phone
(860) 681-1646
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12251 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

249 Spring Lake Rd
Southington, CT 06489-4426

Mailing address

249 Spring Lake Rd
Southington, CT 06489-4426
Phone (860) 681-1646

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
I20230926001659 CT Practitioner - Nurse Practitioner 9537513486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 Pine St
Bristol, CT 06010-6948
Phone (860) 584-1230

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.48 of 100Reported as apm
Quality
83.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12251CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2024 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Oct 1, 2023 Accepting new patients
Midstate Medical Center CurrentSince Sep 1, 2024 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2024 Accepting new patients
Midstate Medical Center Current Accepting new patients
Midstate Medical Center CurrentSince Sep 1, 2024 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients
Hartford Hospital Past Accepting new patients

Locations

339 W Main St
#1
Avon, CT 06001
Phone (860) 696-2150

22 Pine St
Bristol, CT 06010
Phone (860) 229-8346

22 Pine St
Ste 104
Bristol, CT 06010
Phone (860) 314-2002

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: jaimee.dizenzo@xdr.hhchealthdirect.org

Organizations & group practices 9

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 3

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1942983960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 SPRING LAKE RD",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064894426",
            "telephone_number": "860-681-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 SPRING LAKE RD",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064894426",
            "telephone_number": "860-681-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZENZO",
        "first_name": "JAIMEE",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12251",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.