Active NPI
Michelle Jacques, PA-C
- Physician Assistant
- Northborough, MA
National Provider Identifier
1285042671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA4957
- Practice address
- 33 Milk Porridge Cir
Northborough, MA 01532-2308 - Phone
- (516) 241-5183
- NPI assigned
- Jul 29, 2014
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA4957 | MA | Primary |
Addresses
Primary practice location
33 Milk Porridge Cir
Northborough, MA 01532-2308
Mailing address
33 Milk Porridge Cir
Northborough, MA 01532-2308
Phone (516) 241-5183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA4957 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1285042671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 MILK PORRIDGE CIR",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015322308",
"telephone_number": "516-241-5183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 MILK PORRIDGE CIR",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015322308",
"telephone_number": "516-241-5183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUES",
"first_name": "MICHELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-29",
"last_updated": "2022-11-07",
"certification_date": "2022-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA4957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.