Individual provider Active NPI

Jeffrey David Kulpa, PA

  • Student in an Organized Health Care Education/Training Program
  • Hollis, NH
National Provider Identifier
1295401107
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
31 Jambard Rd
Hollis, NH 03049-6521
Phone
(603) 521-5345
NPI assigned
Aug 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

31 Jambard Rd
Hollis, NH 03049-6521

Mailing address

31 Jambard Rd
Hollis, NH 03049-6521
Phone (603) 521-5345

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
I20231122002498 MA Practitioner - Physician Assistant 5496103855 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1030 Main St
Waltham, MA 02451-7447
Phone (781) 894-6900

154 Great Rd
Bedford, MA 01730-2725
Phone (781) 430-8161

228 Washington St
Attleboro, MA 02703-5561
Phone (774) 400-4084

4110 Mystic Valley Pkwy
Suite 2
Medford, MA 02155-6916
Phone (774) 400-4084

648 Old W Central St
Franklin, MA 02038-3826
Phone (774) 400-4084

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Woonsocket Urgent Care, PC CurrentSince Sep 5, 2023 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Feb 1, 2025 Accepting new patients
Patriot Urgent Care Professionals, PC CurrentSince Feb 1, 2025 Accepting new patients
Woonsocket Urgent Care, PC CurrentSince Sep 5, 2023 Accepting new patients
Woonsocket Urgent Care PC CurrentSince Sep 5, 2023 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

1 Wrentham St
Bellingham, MA 02019
Phone (508) 318-4466

103 Providence Hwy
East Walpole, MA 02032
Phone (781) 255-0500

2-4 Mercer Rd
Natick, MA 01760
Phone (508) 318-4466

1019 Trapelo Rd
Waltham, MA 02452
Phone (781) 736-1800

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1295401107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 JAMBARD RD",
            "city": "HOLLIS",
            "state": "NH",
            "postal_code": "030496521",
            "telephone_number": "603-521-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 JAMBARD RD",
            "city": "HOLLIS",
            "state": "NH",
            "postal_code": "030496521",
            "telephone_number": "603-521-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULPA",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, NH

Sources for this page

Verify at the official NPI Registry.