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JOSCO MEDICAL GROUP LLC
NPI 1396314266
Nurse Practitioner in West Hartford, CT

Active since June 23, 2021CLIA 07D2234522 · Waiver
12 N MAIN ST STE 110, WEST HARTFORD, CT 06107(860) 337-9800(860) 263-7329 Get Directions Write a Review

NPPES record last updated: August 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 18, 2021, Jun 23, 2021 (2 updates tracked since 2021).

About Josco Medical Group Llc NPPES

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

JOSCO MEDICAL GROUP LLC (NPI 1396314266) is a healthcare organization registered as a nurse practitioner in West Hartford, Connecticut and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Jacqueline Ortiz-skenderidis, Owner, as its authorized official.

NPPES Registry Identity

NPI1396314266
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameJOSCO MEDICAL GROUP LLC
Location Address12 N MAIN ST STE 110West Hartford, CT 06107-1932
Mailing Address12 North Main Street, Suite 110West Hartford, CT 06107-1932 · (608) 337-9800 · Fax (860) 263-7329
Phone(860) 337-9800
Fax(860) 263-7329
Organization SubpartNo
Authorized OfficialJacqueline Ortiz-skenderidisOwner · (860) 337-9800
Enumeration DateJune 23, 2021
Last NPPES UpdateAugust 18, 20212 updates tracked since enumeration
NPPES CertifiedAugust 18, 2021
✔ NPI 1396314266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
12 N MAIN ST STE 110, West Hartford, CT 06107
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2234522

Josco Medical Group, LLC · West Hartford, CT
Active · expires Aug 31, 2027
CLIA Number07D2234522
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorJacqueline Ortiz-Skenderidis
Laboratory Phone(860) 337-9800
Laboratory LocationJosco Medical Group, LLC12 North Main St, Ste 110, West Hartford, CT 06107
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JACQUELINE ORTIZ-SKENDERIDIS APRN
Nurse Practitioner (Family)
12 N MAIN ST STE 110
WEST HARTFORD, CT 06107
Capitol Planning Region (860) 337-9800

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 Josco Medical Group LLC's NPI number?

The NPI number for Josco Medical Group LLC is 1396314266. It was assigned to this organization in the NPPES registry on June 23, 2021.

Where is Josco Medical Group LLC located?

Josco Medical Group LLC is located at 12 N Main St Ste 110, West Hartford, CT 06107. The listed phone number is (860) 337-9800.

What is Josco Medical Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Josco Medical Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2234522) is associated with this NPI, valid through August 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Josco Medical Group LLC was last updated on August 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.