Active NPI
Jon Pelletier, PA-C
- Surgical Physician Assistant
- Exeter, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 0942
- Practice address
- 3 Alumni Dr
Ste 301
Exeter, NH 03833-2119 - Phone
- (603) 778-7975
- Fax
- (603) 778-7964
- NPI assigned
- Jun 26, 2012
- Last updated
- Jul 16, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA4391 | MA | |
| Surgical Physician Assistant | 363AS0400X | 0942 | NH | Primary |
Addresses
Primary practice location
3 Alumni Dr
Ste 301
Exeter, NH 03833-2119
Mailing address
PO Box 655
Exeter, NH 03833-0655
Phone (603) 778-7975
Other practice location 1
85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA4391 | MA | MD | Medical Physician Assistant |
| 0942 | NH | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth Israel Lahey Health Specialty Care, Inc. | Current | Accepting new patients | |
| Beth Israel Lahey Health Specialty Care, Inc. | Current | Accepting new patients |
Locations
85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700
41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400
Interoperability endpoints
- jpelletier448890@direct.bilh.masshiway.net
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Gloucester, MA
- NPI 1235147760
-
- Emergency Medicine Physician
- Newburyport, MA
- NPI 1396793139
-
- Emergency Medicine Physician
- Newburyport, MA
- NPI 1215724364
-
dba Lahey Institute of Urology, Beverly
- Urology Physician
- Burlington, MA
- NPI 1427161660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1437413374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 655",
"city": "EXETER",
"state": "NH",
"postal_code": "038330655",
"telephone_number": "603-778-7975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 ALUMNI DR",
"address_2": "STE 301",
"city": "EXETER",
"state": "NH",
"postal_code": "038332119",
"telephone_number": "603-778-7975",
"fax_number": "603-778-7964"
}
],
"practiceLocations": [
{
"address_1": "85 Herrick St",
"address_purpose": "LOCATION",
"city": "Beverly",
"state": "MA",
"postal_code": "019151790",
"country_code": "US",
"telephone_number": "978-816-3700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PELLETIER",
"first_name": "JON",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "PA4391",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NH",
"license": "0942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Exeter, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.