Jackie S Fantes, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

261649 Issued in MA

Practice address

10 Gove St
East Boston, MA 02128-1920

Phone

(617) 569-5800

Fax

(617) 568-4780

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26984/brand/1/csg/1/fhir/r4

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.

• Internal Medical Associates-Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1558481879
  Medicare reassignment NPD Authorized official
• Gather Health Primary Care of Massachusetts PC

  • Family Medicine Physician
  • Quincy, MA
  • NPI 1255051850
  Medicare reassignment NPD
• Neighborhealth Corporation

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1316994411
  Medicare reassignment NPD
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1740238526
  NPD (past)
• Springfield Hospital Inc

  • Anesthesiology Physician
  • Springfield, VT
  • NPI 1780657783
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1275530719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Boston St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019042538",
            "country_code": "US",
            "telephone_number": "781-342-4191",
            "fax_number": "833-450-5157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "179 Quincy St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023022966",
            "country_code": "US",
            "telephone_number": "508-283-3154",
            "fax_number": "833-450-5159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Parkingway",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "02169",
            "country_code": "US",
            "telephone_number": "617-820-5968",
            "fax_number": "833-471-5603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021213409",
            "country_code": "US",
            "telephone_number": "617-237-6838",
            "fax_number": "833-450-5158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANTES",
        "first_name": "JACKIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2024-05-08",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "261649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excel Academy Charter School-Boston II
• Excel Physical Therapy, Inc.
• Ali Fadhel, RPH
• Charishma Faigel, DMD
• Phillip M Falkoff, MD
• Bianca Ann Farro, CNP
• Donald L Feldman, DMD
• Danait Fessehatzion, CNP
• Abigail L Fierman, RNP
• Karla Teresita Figueroa Enciso

• Family Medicine Physician in East Boston, MA
• Providers in East Boston, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.

Verify at the official NPI Registry.