Individual provider Active NPI

Chase Jacomini, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Framingham, MA
National Provider Identifier
1053960385
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2275663 Issued in MA
Practice address
600 Worcester Rd Ste 201
Framingham, MA 01702-5360
Phone
(508) 875-2023
Fax
(508) 875-1130
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2275663 MA Primary

Addresses

Primary practice location

600 Worcester Rd Ste 201
Framingham, MA 01702-5360

Mailing address

600 Worcester Rd Ste 201
Framingham, MA 01702-5360
Phone (508) 875-1110

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
I20220124002609 MA Practitioner - Nurse Practitioner 8022400050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

310 Barnstable Rd
Suite 201
Hyannis, MA 02601-2902
Phone (508) 862-0514

600 Worcester Rd
Suite 201
Framingham, MA 01702-5360
Phone (508) 875-1110

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 12, 2022 Accepting new patients
Metrowest Counseling Associates CurrentSince Jan 26, 2022 Accepting new patients
Northeast Health Services Past Accepting new patients

Locations

600 Worcester Rd
Ste 201
Framingham, MA 01702
Phone (508) 875-1110

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1053960385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WORCESTER RD STE 201",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025360",
            "telephone_number": "508-875-1110",
            "fax_number": "508-875-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WORCESTER RD STE 201",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025360",
            "telephone_number": "508-875-2023",
            "fax_number": "508-875-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOMINI",
        "first_name": "CHASE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2275663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.