JEREMIAH RICKETSON
NPI 1659933620
Dentist - Oral and Maxillofacial Surgery in West Hartford, CT

Q: What is Jeremiah Ricketson's NPI number?

The NPI number for Jeremiah Ricketson is 1659933620. It was assigned to this individual provider in the NPPES registry on July 1, 2019.

Q: What is Jeremiah Ricketson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since July 01, 2019PECOS Enrolled

928 FARMINGTON AVE, WEST HARTFORD, CT 06107(860) 232-4606 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 26, 2025, Jun 6, 2023, Jul 1, 2019 (3 updates tracked since 2019).

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About Jeremiah Ricketson NPPES

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

JEREMIAH RICKETSON (NPI 1659933620) is an individual oral and maxillofacial surgery provider in West Hartford, Connecticut, licensed in Connecticut (2.013969) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659933620

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameJEREMIAH RICKETSON

Location Address928 FARMINGTON AVEWest Hartford, CT 06107-2227

Mailing Address1011 N University AveAnn Arbor, MI 48109-1078 · (734) 764-1568 · Fax (734) 615-1415

Phone(860) 232-4606

Sole ProprietorNo

Enumeration DateJuly 1, 2019

Last NPPES UpdateJune 26, 20253 updates tracked since enumeration

NPPES CertifiedJune 26, 2025

✔ NPI 1659933620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in CT · 2.013969

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

928 FARMINGTON AVE, West Hartford, CT 06107

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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 (PECOS)

Jeremiah Ricketson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 06107 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

$75.55 typical visit price

range $19.76 – $149.26

Typical copayment $18.88 (range $4.94 – $37.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 19

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

DR. JOHN WILLIAM ROSENLIEB JR. DMD

Dentist