Individual provider Active NPI

Jessica Dias, FNP

  • Family Nurse Practitioner
  • Canton, MA
National Provider Identifier
1033568233
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2294431 Issued in MA
Practice address
45 Dan Rd
Canton, MA 02021-2852
Phone
(781) 867-2050
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2294431 MA Primary

Addresses

Primary practice location

45 Dan Rd
Canton, MA 02021-2852

Mailing address

PO Box 620550
Newton Lower Falls, MA 02462-0550
Phone (781) 867-2050

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
I20191119001558 MA Practitioner - Nurse Practitioner 9739511445 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2294431MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Treatment Center Inc. CurrentSince Jul 18, 2022 Accepting new patients
Vantage Healthcare LLC CurrentSince Mar 1, 2020 Accepting new patients
Vantage Healthcare Soho PLLC CurrentSince Mar 1, 2020 Accepting new patients
Premier Healthcare Services, LLC Past Accepting new patients

Locations

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

68 N Front St
New Bedford, MA 02740
Phone (508) 689-5576

72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448

1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527

Organizations & group practices 6

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": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1033568233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620550",
            "city": "NEWTON LOWER FALLS",
            "state": "MA",
            "postal_code": "024620550",
            "telephone_number": "781-867-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DAN RD",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212852",
            "telephone_number": "781-867-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAS",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2294431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.