Active NPI
Jasmine F Haque-Ahmed
- Family Nurse Practitioner
- Roxbury, MA
National Provider Identifier
1003457763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN2297584
- Practice address
- 1290 Tremont St
Roxbury, MA 02120-3432 - Phone
- (617) 427-1000
- NPI assigned
- Oct 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN2297584 | MA | Primary |
Addresses
Primary practice location
1290 Tremont St
Roxbury, MA 02120-3432
Mailing address
14 Tamarack Rd
Natick, MA 01760-3038
Phone (646) 408-3829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260112002183 | MA | Order and Referring Only - Nurse Practitioner | 4880070630 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- jhaqueahmed291378@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1003457763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 TAMARACK RD",
"city": "NATICK",
"state": "MA",
"postal_code": "017603038",
"telephone_number": "646-408-3829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 TREMONT ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021203432",
"telephone_number": "617-427-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAQUE-AHMED",
"first_name": "JASMINE",
"middle_name": "F",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-03",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN2297584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.