JACKILYN ANNELLI (PA) – Rheumatology Physician, NPI 1245085315

JACKILYN ANNELLI (PA) is a healthcare provider. based in Norwich, Connecticut. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 6548 (CT). The NPI Number for JACKILYN ANNELLI (PA) is 1245085315

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
JACKILYN ANNELLI (PA)
NPI
1245085315
Phone
(860) 859-9123
Address
12 CASE ST STE 212
Enumeration Date
22 April 2024
Last Update Date
22 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8604951919
Graduation Year
2023 (3 years ago)
PAC ID
9436591500
Group Practice PAC ID
7911800180
Professional Enrollment ID
I20240522000074
Address ID
CT063797909PA37XXXSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,244 PHYSICIAN ASSISTANT in CT

Provider Addresses for JACKILYN ANNELLI (PA)

  • 12 CASE ST STE 212

    NORWICH, CT 063602222

    Phone: (860) 859-9123

    Fax: (860) 859-9124

    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)

CMS reports 47 Open Payments records for all available years, with a total value of $877.

Total Amount is formed as General ($877) + Research ($0) + Ownership ($0) = $877.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Amgen Inc. ($217).

Total Amount

$877

General + Research + Ownership

Payments

47

Total payment records

General Amount

$877

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-05-22

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
I20240522000074IPhysician AssistantCTTBD

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 06360)

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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: 7911800180View full group profile
NameSpecialtyState
Nurse PractitionerCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Orthopedic SurgeryRI
Family PracticeCT
Occupational Therapist In Private PracticeNY
Internal MedicineCT
Physician AssistantMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeCT

Reviews

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Frequently asked questions

How do payers reference JACKILYN ANNELLI (PA)?
For JACKILYN ANNELLI (PA), use NPI 1245085315 as the unique 10-digit identifier.
Is JACKILYN ANNELLI (PA) still an active registrant?
JACKILYN ANNELLI (PA) carries an active NPI according to the public dataset.
What area of care is associated with JACKILYN ANNELLI (PA)?
JACKILYN ANNELLI (PA)'s record emphasizes Rheumatology Physician. Clinical services aligned with this taxonomy classification.
Where in Connecticut is JACKILYN ANNELLI (PA) registered?
Use Norwich, Connecticut as the headline location for JACKILYN ANNELLI (PA) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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