JESSICA MACCORMAC (NPI# 1285933655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285933655 |
| Entity Type | Individual |
| Full Name | JESSICA MACCORMAC |
| Credential | DO |
| Practice Address |
282 Washington St Hartford CT 06106 |
| Mailing Address |
10 Columbus Blvd Fl 4 Hartford CT 06106-1976 |
| Practice Telephone | 8608377681 |
| Mailing Telephone | 8608377681 |
| Mailing Fax Number | 8608375361 |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2018-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
60116 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1425 Portland Ave, Rochester, NY 146213001 | 5859222575 | 5859225033 |
| Street Address |
282 WASHINGTON ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215925037 | Jeffrey S Hyams | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2005-10-06 |
| 1902411127 | Rebecca Katherine Benjamin | Registered Nurse | 282 Washington St, Hartford, CT 06106-3322 | 2020-09-14 |
| 1457960486 | Jillian Scott | Registered Nurse | 282 Washington St, Hartford, CT 06106-3322 | 2020-07-27 |
| 1962029660 | Brittany Athena Molkenthin | Registered Nurse | 282 Washington St, Hartford, CT 06106-3322 | 2020-06-29 |
| 1295358794 | Michaela Kathleen Rotondi | Nurse Practitioner | 282 Washington St, Hartford, CT 06106-3322 | 2020-05-19 |
| 1881216067 | Loida Montanez | Pharmacist | 282 Washington St, Hartford, CT 06106-3322 | 2020-05-11 |
| 1215558853 | Elizabeth Lachat | Social Worker | 282 Washington St, Hartford, CT 06106-3322 | 2020-05-06 |
| 1023638848 | Evan Fusaro | Physician Assistant | 282 Washington St, Hartford, CT 06106-3322 | 2020-04-22 |
| 1992325062 | Lusine Unanyan | Student in an Organized Health Care Education/Training Program | 282 Washington St, Hartford, CT 06106-3322 | 2020-04-19 |
| 1518586577 | Patrick James Gallaway | Student in an Organized Health Care Education/Training Program | 282 Washington St, Hartford, CT 06106-3322 | 2020-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245376771 | Anna George | Pediatrics | 500 Albany Ave, Hartford, CT 06120-2508 | 2007-01-30 |
| 1366454621 | Grael O'brien | Pediatrics | 131 Coventry St, Burgdorf Clinic - 2nd Floor Administration, Hartford, CT 06112-1548 | 2006-08-13 |
| 1821042037 | Zeev Harel | Pediatrics | 500 Albany Ave, Hartford, CT 06120-2508 | 2006-05-20 |
| 1487652491 | Aric Schichor | Pediatrics | 1000 Asylum Ave, Suite 1026, Hartford, CT 06105-1770 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246306 | Pediatric Health Associates of Coneecticut, LLC | Pediatrics | 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 | 2019-07-03 |
| 1073943668 | Pediatric Walk In Care LLC | Pediatrics | 141 B Hazard Avenue, Enfield, CT 06082-5412 | 2013-11-18 |
| 1225319445 | Enfield Pediatric Associates,p.c. | Pediatrics | 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 | 2011-09-01 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1326166125 | Mary A. Simon | Pediatrics | 7 Melrose Dr, Farmington, CT 06032-0893 | 2007-03-27 |
| 1376678516 | Sydney Zane Spiesel | Pediatrics | 8 Lunar Dr, Woodbridge, CT 06525-2352 | 2007-02-21 |
| 1649314279 | Charles Ray Jones | Pediatrics | 111 Park St Ste F, New Haven, CT 06511-5412 | 2007-02-16 |
| 1427110469 | Radhika Malhotra | Pediatrics | 100 Bank St, Suite 307, Seymour, CT 06483-2806 | 2006-12-15 |
| 1386704682 | Andrews Adu Adade | Pediatrics | 18 Hillandale Ave, Stamford, CT 06902-2808 | 2006-12-11 |
| 1982706032 | John Gerald Pitegoff | Pediatrics | 1225 Silver St, Middletown, CT 06457-3920 | 2006-09-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.