Individual provider Active NPI

Rosevan Vickery, RN, FNP-BC

  • Family Nurse Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1285386235
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2330687 Issued in MA
Practice address
1153 Centre St
Jamaica Plain, MA 02130-3446
Phone
(617) 983-7000
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2330687 MA Primary

Addresses

Primary practice location

1153 Centre St
Jamaica Plain, MA 02130-3446

Mailing address

13 Willow St Apt 303
Lynn, MA 01901-1230
Phone (203) 889-8157

Other practice location 1

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

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
I20220328000004 MA Practitioner - Nurse Practitioner 8426443532 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fenway Community Health Center, IncGroup PAC ID 0941299655, 79 clinicians

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2330687MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fenway Community Health Center, Inc CurrentSince Mar 2, 2025 Accepting new patients
Brigham and Women'S Faulkner Hospital, Inc Current Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince May 2, 2022 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Feb 7, 2023 Accepting new patients
Fenway Community Health Center, Inc CurrentSince Mar 2, 2025 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1340 Boylston St
Boston, MA 02215
Phone (617) 267-0900

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

Interoperability endpoints

  • Direct secure messaging: rvickery50107@direct.ctc.masshiway.net
  • Direct secure messaging: vickery.rosevan.fh@direct.partners.masshiway.net

Organizations & group practices 6

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": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1285386235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 WILLOW ST APT 303",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011230",
            "telephone_number": "203-889-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303446",
            "telephone_number": "617-983-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Boylston St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022154302",
            "country_code": "US",
            "telephone_number": "617-267-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "ROSEVAN",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2330687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.