Individual provider Active NPI

Guirlene Jean-Simon, NP

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1326273442
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN213149 Issued in MA
Practice address
1575 Blue Hill Ave
Boston, MA 02126
Phone
(617) 898-9042
Fax
(617) 296-0061
NPI assigned
May 19, 2009
Last updated
Mar 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN213149 MA Primary

Addresses

Primary practice location

1575 Blue Hill Ave
Boston, MA 02126

Mailing address

1575 Blue Hill Ave
Boston, MA 02126
Phone (617) 898-9042

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
I20090611000083 MA Practitioner - Nurse Practitioner 1052461126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1575 Blue Hill Ave
Boston, MA 02126-2122
Phone (617) 296-0061

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN213149MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mattapan Community Health Center Inc CurrentSince Mar 1, 2020 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

Interoperability endpoints

  • Direct secure messaging: gjeansimon164650@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1326273442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 BLUE HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02126",
            "telephone_number": "617-898-9042",
            "fax_number": "617-296-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BLUE HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02126",
            "telephone_number": "617-898-9042",
            "fax_number": "617-296-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-SIMON",
        "first_name": "GUIRLENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN213149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.