DR. TRICIA A. JACOBSEN (NPI# 1154478915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154478915 |
| Entity Type | Individual |
| Full Name | DR. TRICIA A. JACOBSEN |
| Credential | M.D. |
| Practice Address |
491 Gold Star Hwy Suite 100 Groton CT 06340-6226 |
| Practice Telephone | 8604455107 |
| Practice Fax Number | 8604481368 |
| Mailing Telephone | 8604455107 |
| Mailing Fax Number | 8604481368 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 045007 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
491 GOLD STAR HWY SUITE 100 |
| City | GROTON |
| State | CT |
| Zip Code | 06340-6226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700861689 | Elisa Marie Girard | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340-6206 | 2005-12-13 |
| 1962830281 | Stephanie Olivier | Physician Assistant | 491 Gold Star Hwy, Groton, CT 06340-6226 | 2013-10-23 |
| 1760604961 | Eastern Connecticut Dermatology PC | Specialist | 491 Gold Star Hwy, Suite 310, Groton, CT 06340-6226 | 2007-05-03 |
| 1154412674 | Peter T Auerbach | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340 | 2006-09-28 |
| 1972694495 | Michael A Schrempf | Obstetrics & Gynecology | 491 Gold Star Hwy, Suite 100, Groton, CT 06340 | 2006-09-28 |
| 1396848487 | Judy-lynn Shafer | Nurse Practitioner | 491 Gold Star Hwy, Groton, CT 06340 | 2006-09-06 |
| 1437167822 | Judith Conkling Fales | Dentist | 491 Gold Star Hwy, Suite 300, Groton, CT 06340-6226 | 2006-08-03 |
| 1497763718 | David Reid Fales | Dentist | 491 Gold Star Hwy, Suite 300, Groton, CT 06340-6226 | 2006-08-03 |
| 1811950074 | Robert B. Ecker | Dermatology | 491 Gold Star Hwy, Suite 310, Groton, CT 06340 | 2006-04-10 |
| 1215908991 | Diane Meg Davidson | Dermatology | 491 Gold Star Hwy, Suite 310, Groton, CT 06340 | 2006-01-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326154279 | Paula Christian Vaughan | Obstetrics & Gynecology | 100 Boston Rd., Suite E Groton Medical Associates, Groton, MA 01450 | 2006-08-22 |
| 1477667392 | Anthony A Dilullo | Obstetrics & Gynecology | 491 Gold Stary Hwy, Suite 100, Groton, CT 06340 | 2006-08-18 |
| 1700861689 | Elisa Marie Girard | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340-6206 | 2005-12-13 |
| 1407837610 | Ellen Catherine Denigris | Obstetrics & Gynecology | Rout 12 Bldg 449, Naval Ambulatory Care Center Attn: Professional Affairs, Groton, CT 06349-5600 | 2005-11-07 |
| 1154412674 | Peter T Auerbach | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340 | 2006-09-28 |
| 1972694495 | Michael A Schrempf | Obstetrics & Gynecology | 491 Gold Star Hwy, Suite 100, Groton, CT 06340 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336658186 | Amy Frassetto | Obstetrics & Gynecology | 40 Robinwood Rd, Trumbull, CT 06611-4924 | 2017-09-25 |
| 1447770417 | Barbara Lynn Tendler | Obstetrics & Gynecology | 25 River Rd Apt 5101, Wilton, CT 06897-4085 | 2017-06-21 |
| 1528506516 | William P Guinan, Md and Associates LLC | Obstetrics & Gynecology | 25 Oakland Road, South Windsor, CT 06074 | 2017-02-09 |
| 1669822607 | Tania Plaisimond | Obstetrics & Gynecology | 761 Main Ave Ste 100, Norwalk, CT 06851-1080 | 2016-06-21 |
| 1720435092 | Eric Han | Obstetrics & Gynecology | 100 West Campus Drive, Orange, CT 06477 | 2016-05-17 |
| 1093179624 | Jessica Lovesky | Obstetrics & Gynecology | 85 Seymour St Ste 1019, Hartford, CT 06106-5530 | 2016-04-10 |
| 1164895314 | Naugatuck Valley Womens Health Specialists PC | Obstetrics & Gynecology | 686 Straits Turnpike, 2a, Middlebury, CT 06762 | 2015-11-10 |
| 1205218682 | Rui Wang | Obstetrics & Gynecology | 85 Seymour St Ste 525, Hartford, CT 06106-5525 | 2015-06-23 |
| 1164803003 | Ashley Rachelle Christensen | Obstetrics & Gynecology | 5520 Park Ave Ste 302, Trumbull, CT 06611-3466 | 2015-06-16 |
| 1578959086 | Tanya Glenn | Obstetrics & Gynecology | 333 Cedar St Ste 302, New Haven, CT 06510-3206 | 2015-04-10 |
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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.