Individual provider Active NPI

Jacquelyn Feeley, DNP, AGACNP, MS, RN

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1093347890
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2311285 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-7714
NPI assigned
Feb 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2311285 MA
Nurse Practitioner 363L00000X RN2311285 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

399 Revolution Dr
Somerville, MA 02145-1484

Other practice location 1

399 Revolution Dr
Somerville, MA 02145-1484
Phone (774) 270-1219

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
I20200331002313 MA Practitioner - Nurse Practitioner 4587093240 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2311285MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Nurse Practitioner CurrentSince Mar 3, 2020 Accepting new patients
The General Hospital Corporation CurrentSince Oct 23, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Oct 23, 2023 Accepting new patients
Integral Health Partners LLC Nurse Practitioner CurrentSince Jun 1, 2022 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

67 Millbrook St
Ste 406A
Worcester, MA 01606
Phone (508) 283-4513

67 Millbrook St
Ste 406B
Worcester, MA 01606
Phone (413) 512-1529

Interoperability endpoints

  • Direct secure messaging: feeley.jacquelyn.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1093347890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 REVOLUTION DR",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-7714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 Revolution Dr",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "MA",
            "postal_code": "021451484",
            "country_code": "US",
            "telephone_number": "774-270-1219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEELEY",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "DNP, AGACNP, MS, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2311285",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2311285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.