Individual provider Active NPI

Jennifer Herrera Cordones

  • Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1215617311
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2308012 Issued in MA
Practice address
37 Blue Hill Ave Apt 2
Roxbury, MA 02119-3464
Phone
(857) 251-7368
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2308012 MA
Gerontology Nurse Practitioner 363LG0600X RN2308012 MA
Primary Care Nurse Practitioner 363LP2300X RN2308012 MA
Nurse Practitioner 363L00000X RN2308012 MA Primary

Addresses

Primary practice location

37 Blue Hill Ave Apt 2
Roxbury, MA 02119-3464

Mailing address

37 Blue Hill Ave Apt 2
Roxbury, MA 02119-3464

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
I20231106000608 MA Practitioner - Nurse Practitioner 3476900986 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2308012MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upham's Corner Health Committee, Inc. CurrentSince Nov 27, 2023 Accepting new patients
Pathways Healthcare, LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

415 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

500 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

101 Station Dr
Ste 240
Westwood, MA 02090
Phone (781) 706-1079

Interoperability endpoints

  • Direct secure messaging: jherreracordones671332@direct.ochin.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1215617311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BLUE HILL AVE APT 2",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021193464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BLUE HILL AVE APT 2",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021193464",
            "telephone_number": "857-251-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA CORDONES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2308012",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2308012",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2308012",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2308012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.