JESSICA LAUREN THONGPARN (RD) – Registered Dietitian, NPI 1093305674

JESSICA LAUREN THONGPARN (RD) is a healthcare provider. based in Derby, Connecticut. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD. They hold a License No. 957503 (CT). The NPI Number for JESSICA LAUREN THONGPARN (RD) is 1093305674

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA LAUREN THONGPARN (RD)
NPI
1093305674
Phone
(860) 806-5013
Address
204 NEW HAVEN AVE UNIT 8C
Enumeration Date
19 January 2021
Last Update Date
19 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2004 (22 years ago)
PAC ID
3870951924
Group Practice PAC ID
1153318068
Professional Enrollment ID
I20230621002537
Address ID
NH032641126PL16XXXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

116 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in CT

Provider Addresses for JESSICA LAUREN THONGPARN (RD)

  • 204 NEW HAVEN AVE UNIT 8C

    DERBY, CT 064182150

    Phone: (860) 806-5013

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230621002537IRegistered Dietitian Or Nutrition ProfessionalNHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06418)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153318068View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineNC
Physician AssistantNH
Internal MedicineNH
O P H T H A L M O L O G YNH
Nurse PractitionerNH
General SurgeryVA
Nurse PractitionerNH
P S Y C H I A T R YNH
P S Y C H I A T R YNH
General SurgeryNH

Reviews

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Frequently asked questions

Can I cross-check JESSICA LAUREN THONGPARN (RD) using NPI 1093305674?
NPI 1093305674 belongs to JESSICA LAUREN THONGPARN (RD); compare other details if you need extra assurance.
Would JESSICA LAUREN THONGPARN (RD) appear as active to a payer?
You can treat JESSICA LAUREN THONGPARN (RD) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is JESSICA LAUREN THONGPARN (RD)?
JESSICA LAUREN THONGPARN (RD) is associated with Registered Dietitian in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with JESSICA LAUREN THONGPARN (RD)?
Directory geography for JESSICA LAUREN THONGPARN (RD) centers on Derby, Connecticut.
Does JESSICA LAUREN THONGPARN (RD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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