Jennifer Rose Balukonis, APRN
Individual provider Active NPI Nurse Practitioner · Newton, MA
NPI 1144210261 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1144210261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN259428 (MA)
- Practice address
- 2014 Washington St
Newton, MA 02462-1607 - Phone
- (617) 243-6144
- NPI assigned
- Oct 28, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mass General Brigham Medical Group Suburban Massachusetts Inc
Practice addresses (Care Compare)
2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000
Hospital & facility affiliations
- Newton-Wellesley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050927000160 | MA | Practitioner - Nurse Practitioner | 5294769444 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mass General Brigham Medical Group Suburban Massachusetts Inc | Current |
Accepting new patients | |
| Newton Wellesley Hospital | Current | Accepting new patients | |
| Hallmark Health System Inc | Past | Accepting new patients | |
| Parkland Physician Services, Inc. | Past | Accepting new patients |
Locations
2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000
2000 Washington St
Newtonville, MA 02462
Phone (617) 243-6000
Interoperability endpoints
- jenniferbalukonis@snhima.allscriptsdirect.net
- balukonis.jennifer.nwh@direct.partners.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 053185-23 | NH | |
| Nurse Practitioner | 363L00000X | 259428 | MA | |
| Nurse Practitioner | 363L00000X | RN259428 | MA | Yes |
Addresses
Primary practice location
2014 Washington St
Newton, MA 02462-1607
Mailing address
2014 Washington St
Newton, MA 02462-1699
Phone (617) 243-6144
Other practice location 1
6 Tsienneto Rd
Ste 300
Derry, NH 03038-1584
Phone (603) 432-1380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30347938 | Medicaid | NH |
Other providers in Newton, MA
- Carly Forbes Baker
- Elizabeth J. Baker
- Frank J Balboa
- Beth Baldwin
- James Balousek Richardson
- Caroline Carlson Balz
- Bamidbar
- Daniel Banaszek
- Mary Margaret Bandura
- Krysta S. Banfield
All providers in Newton, MA · Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.