Jennifer W Pennoyer, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

CT038483 Issued in CT

Practice address

47 Jolley Dr
Bloomfield, CT 06002-3092

Phone

(860) 243-3020

Fax

(860) 243-3002

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of Connecticut School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer W Pennoyer MD LLCGroup PAC ID 4789605023, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.65 of 100Reported as individual

Quality

74.09

Promoting interoperability

93

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jennifer W Pennoyer MD LLC

  • Dermatology Physician
  • Bloomfield, CT
  • NPI 1841254653
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1982665725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 JOLLEY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023092",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 JOLLEY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023092",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNOYER",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "CT038483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Pasternack, M.D.
• Pranchi Patel
• Tracy E Patel, M.D.
• Marcia Elaine Peck
• Pediatric Partners, LLC
• William P Pennoyer, M.D.
• Perinatal Support & Beyond LLC
• Edith Perlwitz
• Chanae Perry Tanksley, LMSW
• Sydney E Perry, PHARMD

• Dermatology Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.