Individual provider Active NPI

Caitlin Julia Marchenko, NP

  • Family Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1104114792
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
282212 Issued in MA
Practice address
46 Obery St
Dept of Neurology and Neurosurgery
Plymouth, MA 02360-2130
Phone
(508) 210-5925
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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 282212 MA Primary

Addresses

Primary practice location

46 Obery St
Dept of Neurology and Neurosurgery
Plymouth, MA 02360-2130

Mailing address

46 Obery St
Dept of Neurology and Neurosurgery
Plymouth, MA 02360-2130
Phone (508) 210-5925

Other names 1

  • Caitlin Julia Chadwick Former name

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
I20110831000738 MA Practitioner - Nurse Practitioner 0345410296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282212MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince Sep 1, 2014 Accepting new patients
Jordan Physician Associates, Inc. Family CurrentSince Sep 1, 2014 Accepting new patients

Locations

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

46 Obery St
Ste 1
Plymouth, MA 02360

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

Interoperability endpoints

  • Direct secure messaging: cmarchenko462661@direct.bilh.masshiway.net

Organizations & group practices 2

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 2

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1104114792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "address_2": "DEPT OF NEUROLOGY AND NEUROSURGERY",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602130",
            "telephone_number": "508-210-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "address_2": "DEPT OF NEUROLOGY AND NEUROSURGERY",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602130",
            "telephone_number": "508-210-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHENKO",
        "first_name": "CAITLIN",
        "middle_name": "JULIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "282212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "CHADWICK",
            "middle_name": "JULIA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.