Individual provider Active NPI

Joseph Bryn Zell

  • Family Medicine Physician
  • New Haven, CT
National Provider Identifier
1952765646
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63696 Issued in CT
Practice address
367 Cedar St FL Street2
New Haven, CT 06510-3222
Phone
(203) 737-2817
Fax
(203) 785-5713
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 63696 CT Primary

Addresses

Primary practice location

367 Cedar St FL Street2
New Haven, CT 06510-3222

Mailing address

66 Ciccio Rd
Southington, CT 06489-2163
Phone (440) 783-2921

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
I20191016003353 CT Practitioner - Family Practice 4385904911 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Nov 11, 2019 Accepting new patients

Locations

4 Devine St
#A
North Haven, CT 06473
Phone (203) 287-6900

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1952765646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CICCIO RD",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892163",
            "telephone_number": "440-783-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 CEDAR ST FL STREET2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103222",
            "telephone_number": "203-737-2817",
            "fax_number": "203-785-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELL",
        "first_name": "JOSEPH",
        "middle_name": "BRYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "63696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.