Active NPI
Jill Medynski, NP
- Adult Health Nurse Practitioner
- Waltham, MA
National Provider Identifier
1265585384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 213357
- Practice address
- 950 Winter St
Suite 3800
Waltham, MA 02451-1424 - Phone
- (781) 330-9824
- NPI assigned
- Jan 19, 2007
- Last updated
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 213357 | MA | Primary |
Addresses
Primary practice location
950 Winter St
Suite 3800
Waltham, MA 02451-1424
Mailing address
950 Winter St
Suite 3800
Waltham, MA 02451-1424
Phone (781) 330-9824
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150401001544 | MA | Order and Referring Only - Nurse Practitioner | 9335466333 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213357 | MA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437523200000",
"number": "1265585384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 WINTER ST",
"address_2": "SUITE 3800",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511424",
"telephone_number": "781-330-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 WINTER ST",
"address_2": "SUITE 3800",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511424",
"telephone_number": "781-330-9824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDYNSKI",
"first_name": "JILL",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2015-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "213357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
- Meadow Green Nursing Home, Inc. (MeadowGreen Nursing and Rehabilitation)
- Meadow Green Nursing Home, Inc. (Meadow Green Rehabilitation and Nursing Center)
- Felice Ptricia Meadow, D.O.
- Medi-Rents, Inc (Praxair Healthcare Services)
- Mary Beth Medvide, PH.D.
- Carolyn Jean Meehan, LICSW
- Sudha G Mehta, M.D.
- Brandon Jon Meier, DMD
- Anna Meilman, LMHC
- Seshagiri Rao Meka, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.