Individual provider Active NPI

Jane Tevnan, NP

  • Adult Health Nurse Practitioner
  • Millis, MA
National Provider Identifier
1407022619
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
181950 Issued in MA
Practice address
730 Main St
Millis, MA 02054-1612
Phone
(508) 376-2515
Fax
(508) 376-9932
NPI assigned
May 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 181950 MA Primary

Addresses

Primary practice location

730 Main St
Millis, MA 02054-1612

Mailing address

171 Main St Ste 203B
Ashland, MA 01721-1187
Phone (508) 881-3029

Other identifiers 1

IdentifierTypeStateIssuer
110081232AMedicaidMA

Other names 1

  • Jane Tevnan Blanchard Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tevnan.Jane.CRM@direct.partners.masshiway.net

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
I20081215000769 MA Practitioner - Nurse Practitioner 3476615154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

730 Main St
Millis, MA 02054-1612
Phone (508) 376-2515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181950MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles River Medical Associates PC CurrentSince Feb 1, 2023 Accepting new patients
Golden Insight Inc CurrentSince Aug 12, 2021 Accepting new patients
Charles River Medical Associates PC CurrentSince Feb 1, 2023 Accepting new patients

Locations

171 Main St
Ste 203B
Ashland, MA 01721
Phone (508) 881-3029

600 Worcester Rd
Ste 504
Framingham, MA 01702
Phone (508) 875-0922

105 Webster St
Ste 8
Hanover, MA 02339
Phone (781) 312-7457

730 Main St
Millis, MA 02054
Phone (508) 376-2515

Interoperability endpoints

  • Direct secure messaging: tevnan.jane.crm@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1407022619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 203B",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211187",
            "telephone_number": "508-881-3029",
            "fax_number": "508-881-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MAIN ST",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541612",
            "telephone_number": "508-376-2515",
            "fax_number": "508-376-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEVNAN",
        "first_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "181950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110081232A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tevnan.Jane.CRM@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "730 Main St",
            "city": "Millis",
            "state": "MA",
            "country_code": "US",
            "postal_code": "020541612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "BLANCHARD",
            "middle_name": "TEVNAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Millis, MA

Sources for this page

Verify at the official NPI Registry.