NPI Details
Jeanette M Tetrault, MD is an internal medicine in New Haven, CT with 24 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Jeanette M Tetrault, MD NPI is 1003841321. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
Education
Medical School: BOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2001
The provider's business location address is:
1 LONG WHARF DR
NEW HAVEN, CT
ZIP 06511-991
Phone: (203) 781-4600
Fax: (203) 781-4624
The NPI 1003841321 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
The enumeration date for this NPI number is 7/12/2006 and was last updated on 1/24/2022.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207R00000X | Internal Medicine | | 042313 | CONNECTICUT | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 004217099 | MEDICAID | CONNECTICUT | |
| 2 | 004041000 | MEDICAID | CONNECTICUT | |
| 3 | 008001325 | MEDICAID | CONNECTICUT | |
| 4 | 008022626 | MEDICAID | CONNECTICUT | |
| 5 | 008023170 | MEDICAID | CONNECTICUT | |
| 6 | D400081097 | OTHER | CONNECTICUT | MEDICARE GROUP MEMBER PIN/PTAN |
| 7 | 008039745 | MEDICAID | CONNECTICUT | |
| 8 | C01033 | OTHER | CONNECTICUT | MEDICARE PTAN |
| 9 | 001423136 | MEDICAID | CONNECTICUT | |
| 10 | 008042339 | MEDICAID | CONNECTICUT | |
| 11 | 500000315 | MEDICAID | CONNECTICUT | |
| 12 | 008022622 | MEDICAID | CONNECTICUT | |
| 13 | 008024427 | MEDICAID | CONNECTICUT | |
| 14 | 004082260 | MEDICAID | CONNECTICUT | |
| 15 | 004082286 | MEDICAID | CONNECTICUT | |
