Jefferson Radiology, PC

NPI 1396795951ActiveOrganization· Radiology, Diagnostic Radiology· Hartford, CT

Radiology, Diagnostic Radiology in Hartford, Connecticut, registered in NPPES in May 2006. The authorized official on file is Blake G. Graves, Sr Vp Rcm. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI	1396795951
Status	Active
Entity type	Organization
NPI issued	May 12, 2006
Last updated in NPPES	Jun 12, 2026
Certified by provider	Jun 12, 2026

Specialties and licenses

Taxonomy	Code	License	State
Radiology, Diagnostic Radiology Primary	2085R0202X	—	—
Nuclear Medicine	207U00000X	—	—
Radiology, Body Imaging	2085B0100X	—	—
Radiology, Neuroradiology	2085N0700X	—	—
Radiology, Vascular & Interventional Radiology	2085R0204X	—	—
Physician Assistant, Medical	363AM0700X	—	—

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Oct 9, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026	No match	—
New York OMIG · Nov 10, 2026	No match	—
Ohio Medicaid · Nov 10, 2026	No match	—
Pennsylvania Medicheck · Nov 10, 2026	No match	—
Washington HCA · Nov 10, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (CT); Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (NH); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (PR); Part B Supplier - Clinic/Group Practice (TN); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (VT); Part B Supplier - Clinic/Group Practice (WI)

Enrollment (PECOS)

Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (CT); Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (NH); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (PR); Part B Supplier - Clinic/Group Practice (TN); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (VT); Part B Supplier - Clinic/Group Practice (WI)

Medicare sources and data years

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