Individual provider Active NPI

Jeffrey Ayotte, FNP

  • Family Nurse Practitioner
  • Medway, MA
National Provider Identifier
1124300496
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2258269 Issued in MA
Practice address
67D Main St
Medway, MA 02053-1831
Phone
(508) 533-6771
NPI assigned
Sep 13, 2011
Last updated
Jul 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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 2258269 MA Primary

Addresses

Primary practice location

67D Main St
Medway, MA 02053-1831

Mailing address

67D Main St
Medway, MA 02053-1831

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
I20111017000698 MA Practitioner - Nurse Practitioner 3274705249 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
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

366 Shrewsbury St
Worcester, MA 01604-4647
Phone (508) 595-2700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2258269MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince May 30, 2017 Accepting new patients

Locations

366 Shrewsbury St
Worcester, MA 01604
Phone (508) 595-2700

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: jeffrey.ayotte.npi1124300496.reliant@direct.optumcare.masshiway.net

Organizations & group practices 1

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1124300496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67D MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67D MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531831",
            "telephone_number": "508-533-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOTTE",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2258269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medway, MA

Sources for this page

Verify at the official NPI Registry.