Individual provider Active NPI

Jyovani Joubert, PA-C

  • Physician Assistant
  • West Springfield, MA
National Provider Identifier
1083062863
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
134 Capital Dr Ste E
West Springfield, MA 01089-1320
Phone
(413) 733-0010
Fax
(413) 417-2978
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

134 Capital Dr Ste E
West Springfield, MA 01089-1320

Mailing address

PO Box 366
Ludlow, MA 01056-0366
Phone (413) 733-0010

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
I20161018001946 MA Practitioner - Physician Assistant 4789972167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward M Kennedy Community Health Center IncGroup PAC ID 3476512740, 65 clinicians

Practice addresses (Care Compare)

19 Tacoma St
Worcester, MA 01605-3516
Phone (508) 852-1805

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2025 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2025 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients

Locations

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

Interoperability endpoints

  • Direct secure messaging: jyovani.joubert.p1@direct.emkchc.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1083062863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010560366",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CAPITAL DR STE E",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891320",
            "telephone_number": "413-733-0010",
            "fax_number": "413-417-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUBERT",
        "first_name": "JYOVANI",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.