JALICE BRYAN
NPI 1629788799
Nurse Practitioner - Family in New Haven, CT

Q: What is Jalice Bryan's NPI number?

The NPI number for Jalice Bryan is 1629788799. It was assigned to this individual provider in the NPPES registry on November 30, 2022.

Q: What is Jalice Bryan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jalice Bryan was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since November 30, 2022PECOS EnrolledAccepts Medicare Assignment

1351 WHALLEY AVE, NEW HAVEN, CT 06515(203) 889-2691 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 13, 2023, Nov 30, 2022 (2 updates tracked since 2022).

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About Jalice Bryan NPPES

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

JALICE BRYAN (NPI 1629788799) is an individual family provider in New Haven, Connecticut, licensed in Connecticut (11278) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1629788799

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJALICE BRYAN

Location Address1351 WHALLEY AVENew Haven, CT 06515-1149

Mailing Address24 Cambridge StStratford, CT 06614-4711 · (203) 715-1188

Phone(203) 889-2691

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateNovember 30, 2022

Last NPPES UpdateJanuary 13, 20232 updates tracked since enumeration

NPPES CertifiedDecember 28, 2022

✔ NPI 1629788799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CT · 11278

Also ListedInternal MedicineTaxonomy 207R00000X · License 11278 (CT)

1351 WHALLEY AVE, New Haven, CT 06515

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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

Jalice Bryan 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 ID2961872783

PECOS Enrollment IDI20230111002743

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 06515 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.

Other Providers at the Same Location NPPES 17

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

RUT NOEMI PAMPHILE FNP

Nurse Practitioner (Family)