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

Jacquelyne Phanavong

Individual provider Physician Assistant · NPI 1730439597

Jacquelyne Phanavong is a Physician Assistant in New Britain, Connecticut. Qualified in 2012, 14 years ago. Practices with Hartford Healthcare Medical Group Specialists PLLC, a 1,537-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.

Years since qualifying
14
Licensed in
CT
In the registry since
2012
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Practice location Address checks out

100 Grand St
New Britain, CT 06052-2016
Phone: (860) 224-5675
Fax: (860) 224-5774
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 02813 (CT)

Record details

NPI number1730439597
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 19, 2012
Last updated in NPPESFebruary 15, 2017
Mailing address100 Grand St, New Britain, CT 06052-2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Hartford Healthcare Medical Group Specialists Pllc — 1537 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in New Britain