Jack Surgenor, - Dietitian in Durham, CT

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Jack Surgenor, is a Dietitian, Registered based in Durham, Connecticut. Jack Surgenor is licensed to practice in Connecticut (license number 3048) and his current practice location is 20 Laurel Trl, Durham, Connecticut. He can be reached at his office (for appointments etc.) via phone at (203) 464-9095.

NPI number for Jack Surgenor is 1093677650 and his current mailing address is 20 Laurel Trl, Durham, Connecticut. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093677650.

Contact Information

Jack Surgenor,
20 Laurel Trl,
Durham, CT 06422-3400
(203) 464-9095
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameJack Surgenor
GenderMale
SpecialityDietitian, Registered
Location20 Laurel Trl, Durham, Connecticut
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1093677650
  • Provider Enumeration Date: 12/02/2025
  • Last Update Date: 12/02/2025

Medical Identifiers

Medical identifiers for Jack Surgenor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093677650NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered 3048 (Connecticut)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Surgenor is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jack Surgenor,
20 Laurel Trl,
Durham, CT 06422-3400

Ph: (203) 464-9095		Jack Surgenor,
20 Laurel Trl,
Durham, CT 06422-3400

Ph: (203) 464-9095

Reviews and Comments


Dietitian, Registered in Durham, CT

Nourish By Gina Llc
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 352 Main St, Durham, CT 06422
Phone: 203-206-3873    
Gina Barbetta, RD
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 352 Main St, Durham, CT 06422
Phone: 203-206-3873    
Samantha Loffredo,
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Medicare: Not Enrolled in Medicare
Practice Location: 176 Tuttle Rd, Durham, CT 06422
Phone: 860-716-1009    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.