Individual provider Active NPI

Jennifer E Beatty, PA-C, MSPT

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1073634663
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 525-8470
NPI assigned
Apr 2, 2007
Last updated
Apr 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16647 MA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

75 Francis St
Asb II
Boston, MA 02115-6110

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
I20101222000771 MA Practitioner - Physician Assistant 6709074438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16647MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 29, 2010 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

Interoperability endpoints

  • Direct secure messaging: beatty.jennifer.bwh@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1073634663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "ASB II",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-525-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "PA-C, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16647",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.