Individual provider Active NPI

Jennifer Rose Collins, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1295247765
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7016 Issued in MA
Practice address
800 Washington St
Boston, MA 02111
Phone
(617) 636-4720
NPI assigned
Oct 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7016 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other practice location 1

450 William S Canning Blvd
Fall River, MA 02721-5610
Phone (508) 973-0250

Other practice location 2

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7044

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcollins47049@direct.southcoast.org

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
I20190620001975 MA Practitioner - Physician Assistant 6507190840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA7016MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jun 17, 2019 Accepting new patients
Southcoast Physicians Group, Inc. Past Accepting new patients
Southern New England Radiology Inc Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

Interoperability endpoints

  • Direct secure messaging: jcollins47049@direct.southcoast.org
  • Direct secure messaging: collins.jennifer.nsmc@direct.partners.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1295247765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-4720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 William S Canning Blvd",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027215610",
            "country_code": "US",
            "telephone_number": "508-973-0250",
            "fax_number": "508-973-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "534 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027205281",
            "country_code": "US",
            "telephone_number": "508-973-7044",
            "fax_number": "508-973-7667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcollins47049@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "450 William S Canning Blvd",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027215610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.