Jacqueline Mcsally Donaldson · Surgical Physician Assistant

5520 Park Ave, Trumbull, CT 06611-3463

Overview

Jacqueline Mcsally Donaldson is a Surgical Physician Assistant practicing in Trumbull, Connecticut. The National Provider Identifier (NPI) is #1417415084, which was assigned on March 3, 2019, and the registration record was last updated on October 7, 2025. The practitioner's main practice location is at 5520 Park Ave, Trumbull, CT 06611-3463; the contact telephone number is 2032617262. The primary taxonomy of Jacqueline Mcsally Donaldson is Surgical Physician Assistant (363AS0400X), with specialization in Surgical. Jacqueline Mcsally Donaldson is licensed to practice in the state of North Carolina (#0010-08914), Connecticut (#6876).

Provider Information

NPI 1417415084
Entity Type Individual
Provider Name MRS. JACQUELINE MCSALLY
Other Name JACQUELINE MCSALLY DONALDSON
(Former Name)
Gender Female
Credential PA-C
Practice Address 5520 Park Ave
Trumbull
CT 06611-3463
Practice Telephone 2032617262
Mailing Address 1290 Silas Deane Hwy
Hhc Cvo
Wethersfield
CT 06109-4337
Mailing Telephone 8609725507
Mailing Fax Number 8609727040
Certification Date 2025-10-07
Enumeration Date 2019-03-03
Last Update Date 2025-10-07
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 3173857521
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name JACQUELINE MCSALLY DONALDSON
Primary Specialty PHYSICIAN ASSISTANT
Organization Legal Name YALE UNIVERSITY
Address 800 Howard Ave
New Haven
CT 06519-1369

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N363A00000XPhysician Assistant0010-08914NC
Y363AS0400XPhysician AssistantSurgical6876CT

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
1159850NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS (NCCPA)Other
110-622-459AMERICAN ACADEMY OF PAS (AAPA)Other
100274093WIMEDICAID

Secondary Practice Locations

AddressTelephoneFax
2800 Main St, Bridgeport, CT 06606420147521054364752106512
2825 Lyndhurst Ave Ste 101, Winston Salem, NC 2710341463362774075

Taxonomy Information

Primary Taxonomy

Code 363AS0400X
Taxonomy Surgical Physician Assistant
Classification Physician Assistant
Specialization Surgical
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: Definition to come...

Other Taxonomy

Code 363A00000X
Taxonomy Physician Assistant
Classification Physician Assistant
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Brianna Jade Alex 1900 North Loop W Ste 670, Houston, TX 77018-8119Surgical Physician Assistant2025-10-07
Sharon Elizabeth Lauster 1575 Pine Ridge Rd, Naples, FL 34109-2107Surgical Physician Assistant2025-09-30
Nicholas Mondore 1367 Washington Ave Ste 200, Albany, NY 12206-1043Surgical Physician Assistant2025-09-23
Maginta Smith 1501 N Campbell Ave, Tucson, AZ 85724-0001Surgical Physician Assistant2025-09-30
American Orthopedics Surgical Assist, LLC 10 Enterprise Blvd Ste 209, Greenville, SC 29615-3554Surgical Physician Assistant2025-10-08
Holly Rusch · Holly Hamilton 4309 W Medical Center Dr Ste B310, Mchenry, IL 60050-8441Surgical Physician Assistant2025-09-23
Tiwaloluwa James 8600 Old Georgetown Rd, Bethesda, MD 20814-1422Surgical Physician Assistant2025-10-10
Sanik J Patel 10730 Medlock Bridge Rd, Johns Creek, GA 30097-2637Surgical Physician Assistant2025-10-01
M Ward S Surgical Associates 10620 Southern Highlands Pkwy Ste 110-438, Las Vegas, NV 89141-4371Surgical Physician Assistant2025-09-29
Lisa Tangri 1275 N High St, Hillsboro, OH 45133-5200Surgical Physician Assistant2025-10-06
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Location Information

Street Address 5520 PARK AVE
City TRUMBULL
State CT
Zip Code 06611-3463
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Krystal Kelly 5520 Park Ave, Trumbull, CT 06611-3463Oncology Pharmacist2025-09-15
Black Rock Tpk Med Grp 5520 Park Ave, Suite 203, Trumbull, CT 06611-3463Hematology & Oncology Physician2005-07-12
Caroline Ann Carruth 5520 Park Ave, Trumbull, CT 06611-3463Physician Assistant2021-10-27
Ana Carolina Meyer 5520 Park Ave, Trumbull, CT 06611-3463Women's Health Nurse Practitioner2025-01-27
Stephanie Miller 5520 Park Ave, Trumbull, CT 06611-3463Family Nurse Practitioner2017-07-15
Katherine Aileen Duarte 5520 Park Ave, Trumbull, CT 06611-3463Community Health Nurse Practitioner2024-12-30
Ashley Rachelle Christensen 5520 Park Ave Ste 302, Trumbull, CT 06611-3466Obstetrics & Gynecology Physician2015-06-16
Shelby L Blackley 5520 Park Ave Ste Wp-2300, Trumbull, CT 06611-3463Surgical Physician Assistant2020-06-29
Christine Cunningham 5520 Park Ave # Wp1-200, Trumbull, CT 06611-3463Nurse Practitioner2025-06-11
Elizabeth Miller Gaa 5520 Park Ave, Trumbull, CT 06611-3463Registered Nurse2023-12-12
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Connecticut In Home Assistance LLC 925 White Plains Rd, Trumbull, CT 06611Respite Care2007-05-03
Lauren K Meli 2 Corportate Drive, Suite 209, Trumbull, CT 06611Social Worker2008-11-24
Qmg5,Llc 57 Monroe Tpke, Trumbull, CT 06611-1315Urgent Care Clinic/Center2021-01-14
Ptsma Inc 115 Technology Dr, Ste B100, Trumbull, CT 06611Rehabilitation Clinic/Center2006-03-16
Michael G Saad 6527 Main St, Trumbull, CT 06611-1385Clinical Social Worker2025-09-29
Jaycie Deleon Perez 6515 Main St, 1st Floor, Suite #6, Trumbull, CT 06611Registered Dietitian2025-05-23
Natalie Colicci-Favretto 2 Corporate Dr Ste 206, Trumbull, CT 06611-1376Nutritionist2009-06-03
Ethan Samuel Pollack 6540 Main St Ste 5, Trumbull, CT 06611-1364Physical Therapist2025-08-09
Grandhi LLC 15 Corporate Dr Ste 1-1, Trumbull, CT 06611-1351Durable Medical Equipment & Medical Supplies2016-04-25
John-Paul Ayala 15 Corporate Dr, Trumbull, CT 06611-1351Internal Medicine Physician2006-05-08
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.