Individual provider Active NPI

Jessica Zina-Duarte, M.D.

  • Pediatrics Physician
  • Chicopee, MA
National Provider Identifier
1407199847
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
265531 Issued in MA
Practice address
444 Montgomery Street
Pediatrics
Chicopee, MA 01020
Phone
(413) 594-3111
Fax
(413) 598-7115
NPI assigned
Apr 4, 2013
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 265531 MA
Pediatrics Physician 208000000X 265531 MA Primary

Addresses

Primary practice location

444 Montgomery Street
Pediatrics
Chicopee, MA 01020

Mailing address

444 Montgomery Street
Pediatrics
Chicopee, MA 01020
Phone (413) 594-3111

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
I20160725000425 MA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0547497190 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265531MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Jul 20, 2017 Accepting new patients
Riverbend Medical Group, Inc. Pediatrics CurrentSince Jul 20, 2017 Accepting new patients
Mwa,PC Pediatrics Past Accepting new patients

Locations

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: jzinaduarte2389724@direct.trinity-health.org

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1407199847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY STREET",
            "address_2": "PEDIATRICS",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "01020",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY STREET",
            "address_2": "PEDIATRICS",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "01020",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINA-DUARTE",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "265531",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "265531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.