NPIMap

Individual provider Active NPI

Jessica Erin Kreshover, MD, MS

  • Urology Physician
  • Boston, MA
National Provider Identifier
1346415916
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
265357 Issued in NY
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-0122
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 265357 NY Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

450 Lakeville Rd
Suite M41
New Hyde Park, NY 11042-1118
Phone (516) 734-8500

Other practice location 1

450 Lakeville Rd
Suite M41
New Hyde Park, NY 11042-1118
Phone (516) 734-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120730000328 NY Practitioner - Urology 6103082540 Reassigns benefits to 1 organization
I20240412001096 MA Practitioner - Urology 6103082540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Virginia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
265357NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince May 1, 2024 Accepting new patients
General Hospital Corp Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
The General Hospital Corporation CurrentSince May 1, 2024 Accepting new patients
North Shore-Lij Medical PC Urology CurrentSince Jul 1, 2012 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

450 Lakeville Rd
Ste M41
New Hyde Park, NY 11042
Phone (516) 734-8567

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: kreshover.jessica.mgh@direct.partners.masshiway.net
  • Direct secure messaging: jessicakreshover@nslijmedgr.allscriptsdirect.net

Organizations & group practices 5

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 5

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1346415916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD",
            "address_2": "SUITE M41",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421118",
            "telephone_number": "516-734-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Lakeville Rd",
            "address_2": "Suite M41",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110421118",
            "country_code": "US",
            "telephone_number": "516-734-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRESHOVER",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "credential": "MD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "265357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.