Jacquelyn Rawan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7210338 Issued in MA

Practice address

700 Crown Colony Dr
Quincy, MA 02169-0924

Phone

(617) 472-3400

NPI assigned

Sep 9, 2021

Last updated

Sep 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrawan460072@direct.bilh.masshiway.net

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.

• Medical Care of Boston Management Corporation

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1437196359
  Medicare reassignment Care Compare group NPD

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

• Beth Israel Deaconess Hospital Milton Inc

  • General Acute Care Hospital
  • Milton, MA
  • NPI 1174618953
  Care Compare affiliation
• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1326717612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 KINNICUTT RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016021548",
            "telephone_number": "508-439-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CROWN COLONY DR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690924",
            "telephone_number": "617-472-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWAN",
        "first_name": "JACQUELYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "7210338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "7210338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Randall
• Sandra C Range, LMHC
• Lindsay Ellen Rankin
• Edward Rao, MD
• Sarah C Raulino
• Ellen Raymond
• Sandra L. Raymond, C.C.C.,SLP
• Rays of Hope Psychiatric Services, PLLC
• RC Quincy LLC
• Re-Anchored Therapy

• Family Nurse Practitioner in Quincy, MA
• Providers in Quincy, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.