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KATHRYN E JACK APRN
NPI 1265456347
Nurse Practitioner - Adult Health in Meriden, CT

Active since July 26, 2006PECOS EnrolledAccepts Medicare Assignment
85.07/100
CMS Quality Rating
455 LEWIS AVE, SUITE 106, MERIDEN, CT 06451(203) 886-0036(203) 886-0072 Get Directions Write a Review

NPPES record last updated: November 5, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kathryn E Jack Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHRYN E JACK APRN (NPI 1265456347) is an individual adult health provider in Meriden, Connecticut, licensed in Connecticut (002455) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1265456347
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameKATHRYN E JACKCredential: APRN
Location Address455 LEWIS AVE, SUITE 106Meriden, CT 06451-2121
Mailing Address2139 Silas Deane HwyRocky Hill, CT 06067-2336 · (860) 257-4131 · Fax (860) 257-4519
Phone(203) 886-0036
Fax(203) 886-0072
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJuly 26, 2006
Last NPPES UpdateNovember 5, 2013
✔ NPI 1265456347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in CT · 002455
Also ListedNurse PractitionerTaxonomy 363L00000X · License 002455 (CT)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 002455 (CT)
455 LEWIS AVE, Meriden, CT 06451
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Other Identifiers 4

Medicare UPINP47490CT
Medicaid004219491CT
Medicare PIND400051507CT
Medicare PIN500000762CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathryn E Jack Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426054479
PECOS Enrollment IDI20061013000402
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06451 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.07/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality89.7
Promoting Interoperability83
Improvement Activities40
Cost68.33

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN JO M.D.
Internal Medicine (Gastroenterology)
455 LEWIS AVE, SUITE 106
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 886-0036
CONNECTICUT SURGICAL GROUP, PC
Urology
455 LEWIS AVE, SUITE 210
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 238-1241
JAMES JOSEPH GALLAGHER III M.D.
Surgery (Vascular Surgery)
455 LEWIS AVE, SUITE 203
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 634-1900
DR. AURANGZEB A ALI M.D.
Surgery
455 LEWIS AVE, SUITE 216
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 634-0134
LOUIS MEYER MD
Surgery
455 LEWIS AVE
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 238-2691
GARY MARK COHEN M.D.
Internal Medicine (Gastroenterology)
455 LEWIS AVE, SUITE 106
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 886-0036
MEDICAL ONCOLOGY & HEMATOLOGY PC
Clinical Medical Laboratory
455 LEWIS AVE
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 238-7747
SUSAN ALSAMARAI MD
Internal Medicine (Hematology & Oncology)
455 LEWIS AVE, MIDSTATE MEDICAL GROUP, PC
MERIDEN, CT 06451
South Central Connecticut Planning Region (203) 238-7747

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathryn Jack's NPI number?

The NPI number for Kathryn Jack is 1265456347. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Kathryn Jack located?

Kathryn Jack practices at 455 Lewis Ave Suite 106, Meriden, CT 06451. The listed phone number is (203) 886-0036.

What is Kathryn Jack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kathryn Jack enrolled in Medicare?

Yes. Kathryn Jack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kathryn Jack was last updated on November 5, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.