Individual provider Active NPI

Jennifer A. Stanhope, NP

  • Gerontology Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1376927400
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2279896 Issued in MA
Practice address
630 Plantation St
Worcester, MA 01605-2038
Phone
(508) 852-0600
Fax
(508) 853-7149
NPI assigned
Jul 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2279896 MA Primary

Addresses

Primary practice location

630 Plantation St
Worcester, MA 01605-2038

Mailing address

630 Plantation St
Wot 12TH FL
Worcester, MA 01605-2038
Phone (508) 368-5532

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
I20150923001034 MA Practitioner - Nurse Practitioner 1355658378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integral Health Partners LLCGroup PAC ID 2264842087, 8 clinicians

Practice addresses (Care Compare)

67 Millbrook St
Suite 406a
Worcester, MA 01606-2845
Phone (413) 512-1529

Merit-based Incentive Payment System (MIPS)

Final score
24.15 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2279896MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Health Partners LLC CurrentSince Aug 13, 2020 Accepting new patients
Worcester Internal Medicine, Inc. CurrentSince Jul 12, 2017 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

67 Millbrook St
Ste 406A
Worcester, MA 01606
Phone (508) 283-4513

416 Belmont St
Worcester, MA 01604
Phone (508) 756-1808

416 Belmont St
Ste 1
Worcester, MA 01604
Phone (508) 756-6609

67 Millbrook St
Ste 406B
Worcester, MA 01606
Phone (413) 512-1529

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFCDD
  • Direct secure messaging: jstanhope@integralhealthpartners.kareodirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Holden Rehabilitation and Nursing CenterHolden, MA, CCN 225002 Skilled nursing facility Adp of the SNF Dec 17, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1376927400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "address_2": "WOT 12TH FL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-5532",
            "fax_number": "508-853-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-852-0600",
            "fax_number": "508-853-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANHOPE",
        "first_name": "JENNIFER",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2279896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.