Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Conrad Justin Poole

Individual provider Physician Assistant · NPI 1902794910

Conrad Justin Poole is a Physician Assistant in New Haven, Connecticut. Qualified in 2025, 1 year ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
1
Licensed in
CT
In the registry since
2025

Practice location Address checks out

20 York St
New Haven, CT 06510-3220
Phone: (203) 688-4242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7179 (CT)

Record details

NPI number1902794910
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 26, 2025
Last updated in NPPESJune 26, 2025
Certification dateJune 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in New Haven