Individual provider Active NPI

Jeanette Cloutier, M.D.

  • Family Medicine Physician
  • Lawrence, MA
National Provider Identifier
1174680748
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233168 Issued in MA
Practice address
34 Haverhill Street
Lawrence, MA 01841-2884
Phone
(978) 689-6683
NPI assigned
Jan 3, 2007
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 233168 MA Primary

Addresses

Primary practice location

34 Haverhill Street
Lawrence, MA 01841-2884

Mailing address

260 Pleasant St Unit 104
Berlin, MA 01503-3004
Phone (508) 471-4721

Other practice location 1

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 689-6683

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000326 MA Practitioner - Family Practice 9133282767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward M Kennedy Community Health Center IncGroup PAC ID 3476512740, shared by 5 NPIs, 65 clinicians

Practice addresses (Care Compare)

354 Waverley St
Framingham, MA 01702-7079
Phone (508) 370-0113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
233168MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
President & Fellows of Harvard College CurrentSince Jul 3, 2023 Accepting new patients
President and Fellows of Harvard College CurrentSince Jul 3, 2023 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

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, 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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1174680748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 PLEASANT ST UNIT 104",
            "city": "BERLIN",
            "state": "MA",
            "postal_code": "015033004",
            "telephone_number": "508-471-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL STREET",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-689-6683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Haverhill St",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018412884",
            "country_code": "US",
            "telephone_number": "978-689-6683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "233168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.