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

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: October 25, 2026.

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

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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

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.

Medicare Billing Reassignment

Medicare enrollment records show Jalice Bryan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South-West Community Health Center, Inc
17 mi
Mental Health (Including Community Mental Health Center)
46 ALBION ST
Bridgeport, CT 06605
  • Reassigned Medicare billing, Connecticut enrollment
  • 126 clinicians in this Medicare group
NPI 1699703686 (203) 330-6000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 889-2676
SAMANTHA BIXBY
Nurse Practitioner
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 889-2676
DR. PATRICK F CORBETT PHARMD
Pharmacist
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 745-3823
CRAIG L MANBAUMAN NP
Nurse Practitioner (Family)
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (347) 217-7914
NHURX LLC
Pharmacy (Community/Retail Pharmacy)
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 745-0030
MEGAN PERUCKI
Nurse Practitioner (Family)
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (475) 238-8178
NHURX LLC
Pharmacy (Long Term Care Pharmacy)
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 745-0030
CAMDEN SVEC PHARMD
Pharmacist
1351 WHALLEY AVE
NEW HAVEN, CT 06515
South Central Connecticut Planning Region (203) 745-3823

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 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.

Where is Jalice Bryan located?

Jalice Bryan practices at 1351 Whalley Ave, New Haven, CT 06515. The listed phone number is (203) 889-2691.

What is Jalice Bryan's specialty?

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

Is Jalice Bryan enrolled in Medicare?

Yes. Jalice Bryan 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 organization bills Medicare for Jalice Bryan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jalice Bryan reassigns Medicare benefits to South-West Community Health Center, Inc (Bridgeport, CT). The 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 Jalice Bryan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jalice Bryan accept?

Health plans from Anthem Blue Cross and Blue Shield list Jalice Bryan 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 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.