Individual provider Active NPI

Jeanne M Rousseau, D.O.

  • Family Medicine Physician
  • Worcester, MA
National Provider Identifier
1366425035
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
79383 Issued in MA
Practice address
26 Queen Street
Worcester, MA 01610-2473
Phone
(508) 860-7777
Fax
(508) 860-7055
NPI assigned
Nov 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 79383 MA Primary

Addresses

Primary practice location

26 Queen Street
Worcester, MA 01610-2473

Mailing address

26 Queen Street
Worcester, MA 01610-2473
Phone (508) 860-7962

Other identifiers 1

IdentifierTypeStateIssuer
3126749MedicaidMA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000512 MA Practitioner - Family Practice 9234170887 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Family Health Center of Worcester, Inc.Group PAC ID 4789670985, 94 clinicians

Practice addresses (Care Compare)

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
79383MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Worcester, Inc. CurrentSince Apr 3, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Sep 12, 1994 Accepting new patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Sep 12, 1994 Accepting new patients
Raymond Zhou MD PC CurrentSince Jul 11, 2022 Accepting new patients
Family Health Center of Worcester, Inc. CurrentSince Apr 3, 2023 Accepting new patients

Locations

105 E Main St
Milford, MA 01757
Phone (508) 381-2740

415 Boston Tpke
Ste 105
Shrewsbury, MA 01545
Phone (508) 845-8200

291 Lincoln St
Ste 302
Worcester, MA 01605
Phone (508) 792-1413

291 Lincoln St
Ste 105
Worcester, MA 01605
Phone (508) 752-0121

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

330 Grove St
Worcester, MA 01605
Phone (508) 232-7555

Interoperability endpoints

  • Direct secure messaging: jrousseau47799@direct.ctc.masshiway.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.

NPI Registry JSON

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1366425035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7962",
            "fax_number": "508-796-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7777",
            "fax_number": "508-860-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "JEANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-27",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "79383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3126749",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.