DR. JOHN JEFFREY NELSON M.D.
NPI 1376540005
Internal Medicine in Mystic, CT
About Dr. John Jeffrey Nelson M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN JEFFREY NELSON M.D. (NPI 1376540005) is an individual internal medicine provider in Mystic, Connecticut, licensed in Connecticut (034771) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Boston University School Of Medicine (1992).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. John Jeffrey Nelson M.d. 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.
Medicare Billing Reassignments
3Medicare enrollment records show John Nelson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mystic, CT 06355
- Reassigned Medicare billing, Connecticut enrollment
- 2 clinicians in this Medicare group
Springfield, MA 01151
- Reassigned Medicare billing, Connecticut enrollment
- Medicare enrollment name: Ipc Hospitalists Of New England PC
- 88 clinicians in this Medicare group
Baton Rouge, LA 70816
- Reassigned Medicare billing, Connecticut enrollment
- 127 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06355 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 John Nelson's NPI number?
The NPI number for John Nelson is 1376540005. It was assigned to this individual provider in the NPPES registry on July 7, 2005.
Where is John Nelson located?
John Nelson practices at 11 Main St Unit 11-205, Mystic, CT 06355. The listed phone number is (860) 421-1090.
What is John Nelson's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is John Nelson enrolled in Medicare?
Yes. John Nelson 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.
Which organizations bill Medicare for John Nelson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Nelson reassigns Medicare benefits to 3 organizations: Value In Prevention Of Connecticut PLLC (Mystic, CT), Ipc Hospitalists Of New England, P.C. (Springfield, MA) and Hospital Medicine Associates LLC (Baton Rouge, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Nelson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Nelson accept?
Health plans from Anthem Blue Cross and Blue Shield list John Nelson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for John Nelson was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. John Jeffrey Nelson, M.D. · NPI 1376540005
Internal Medicine physician in Mystic, Connecticut. Individual provider, active in the CMS NPPES registry since July 7, 2005.
## Identity
- **NPI:** 1376540005 (Entity type: Individual)
- **Enumerated:** July 7, 2005
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 034771 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 11 MAIN ST UNIT 11-205, Mystic, CT 06355-3654
- **Phone:** (860) 421-1090 · **Fax:** (860) 421-1091
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Value In Prevention Of Connecticut PLLC (NPI 1487495313, Mystic, CT); Ipc Hospitalists Of New England, P.C. (NPI 1659555266, Springfield, MA); Hospital Medicine Associates LLC (NPI 1093758781, Baton Rouge, LA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Boston University School Of Medicine, class of 1992
## Record status
- **NPPES last updated:** September 11, 2024
- **Other identifiers:** Medicaid 001347716 (CT)
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Source: [NPI Profile](https://npiprofile.com/npi/1376540005) · Data from the CMS NPPES public registry.