Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jason William Ptak, PA-C

Individual provider Physician Assistant · NPI 1437566338

Mr. Jason William Ptak, PA-C is a Physician Assistant in Hartford, Connecticut. Qualified in 2014, 12 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group and accepts Medicare assignment. Licensed in Connecticut and Idaho.

Years since qualifying
12
Licensed in
CT, ID
In the registry since
2014
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

500 Albany Ave
Hartford, CT 06120-2508
Phone: (860) 249-9625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 005617 (CT)
Physician Assistant Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA-1993 (ID)

Record details

NPI number1437566338
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 13, 2014
Last updated in NPPESMarch 13, 2023
Certification dateMarch 13, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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