Individual provider Active NPI

Jessica Leigh Mezoff, PA-C

  • Medical Physician Assistant
  • Boston, MA
National Provider Identifier
1013457472
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA6062 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(781) 266-6249
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA6062 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

80 N Warren St Apt 34
Woburn, MA 01801-4160
Phone (781) 266-6249

Other names 1

  • Ms. Jessica Leigh Johnston Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719000144 MA Practitioner - Physician Assistant 3476823832 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA6062MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 7, 2017 Accepting new patients
Urgent Care Operations PC CurrentSince Jun 1, 2021 Accepting new patients
Urgent Care Operations, PC CurrentSince Jun 1, 2021 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jan 28, 2026 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 7, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 7, 2017 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 7, 2017 Accepting new patients

Locations

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: mezoff.jessica.nsmc@direct.partners.masshiway.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1013457472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N WARREN ST APT 34",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018014160",
            "telephone_number": "781-266-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "781-266-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZOFF",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "JOHNSTON",
            "middle_name": "LEIGH",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.