Kathryn E Jack, APRN - Medicare Nurse Practitioner in Meriden, CT

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Kathryn E Jack, APRN is a medicare enrolled "Nurse Practitioner - Adult Health" in Meriden, Connecticut. She graduated from nursing school in 2000 and has 24 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Connecticut Gi Pc and her current practice location is 455 Lewis Ave, Suite 106, Meriden, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 886-0036.

Kathryn E Jack is licensed to practice in Connecticut (license number 002455) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1265456347.

Contact Information

Kathryn E Jack, APRN
455 Lewis Ave, Suite 106,
Meriden, CT 06451-2121
(203) 886-0036
(203) 886-0072

Map and Direction




Provider's Profile

Full NameKathryn E Jack
GenderFemale
SpecialityNurse Practitioner
Experience24 Years
Location455 Lewis Ave, Meriden, Connecticut
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kathryn E Jack graduated from nursing school in 2000
  NPI Data:
  • NPI Number: 1265456347
  • Provider Enumeration Date: 07/26/2006
  • Last Update Date: 11/05/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 8426054479
  • Enrollment ID: I20061013000402

Medical Identifiers

Medical identifiers for Kathryn E Jack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265456347NPI-NPPES
004219491MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 002455 (Connecticut)Secondary
363LA2200XNurse Practitioner - Adult Health 002455 (Connecticut)Primary
363LF0000XNurse Practitioner - Family 002455 (Connecticut)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Connecticut Gi Pc9830110758185

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kathryn E Jack allows following entities to bill medicare on her behalf.
Entity NameConnecticut Gi Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023124625
PECOS PAC ID: 9830110758
Enrollment ID: O20070112000011

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. Kathryn E Jack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kathryn E Jack, APRN
2139 Silas Deane Hwy,
Rocky Hill, CT 06067-2336

Ph: (860) 257-4131		Kathryn E Jack, APRN
455 Lewis Ave, Suite 106,
Meriden, CT 06451-2121

Ph: (203) 886-0036

Reviews and Comments


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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.