Individual provider Active NPI

Jennifer L Dearden, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1194787556
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
219723 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-7737
NPI assigned
Apr 3, 2006
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41466 CT
Anesthesiology Physician 207L00000X 219723 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

21 Grand Hill Dr
Dover, MA 02030-1734
Phone (617) 447-4386

Other practice location 1

365 Montauk Ave
New London, CT 06320-4769
Phone (860) 442-0711

Other practice location 2

25 Wells St
Westerly, RI 02891-2934
Phone (401) 596-7477 ext. 3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT, RI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050119000810 MA Practitioner - Anesthesiology 4789633504 Reassigns benefits to 3 organizations
I20240819001981 CT Practitioner - Anesthesiology 4789633504 Reassigns benefits to 1 organization
I20241220000222 RI Practitioner - Anesthesiology 4789633504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
CHMC Anesthesia Foundation IncGroup PAC ID 0446155568, 131 clinicians
Winchester Anesthesia Associates, IncGroup PAC ID 7315977196, 64 clinicians

Practice addresses (Care Compare)

25 Wells St
Westerly, RI 02891-2922
Phone (401) 596-6000

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 444-3735

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 756-2190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219723MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Winchester Anesthesia Associates 2 Inc Anesthesiology CurrentSince Feb 1, 2022 Accepting new patients
CHMC Anesthesia Foundation Inc Anesthesiology CurrentSince Dec 1, 2004 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Aug 26, 2024 Accepting new patients
Winchester Anesthesia Associates, Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
Ofc
Boston, MA 02115
Phone (617) 355-8083

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

45 East Ave
Westerly, RI 02891
Phone (401) 596-6000

Interoperability endpoints

  • Direct secure messaging: jdearden22236@direct.bostonchildrens.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1194787556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRAND HILL DR",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020301734",
            "telephone_number": "617-447-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Montauk Ave",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204769",
            "country_code": "US",
            "telephone_number": "860-442-0711",
            "fax_number": "860-443-4458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Wells St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912934",
            "country_code": "US",
            "telephone_number": "401-596-7477 x3950",
            "fax_number": "401-596-0821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARDEN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "41466",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "219723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.