Individual provider Active NPI

Jon Pelletier, PA-C

  • Surgical Physician Assistant
  • Exeter, NH
National Provider Identifier
1437413374
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0942 Issued in NH
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140710002273 MA Practitioner - Physician Assistant 1456599893 Reassigns benefits to 3 organizations

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA4391MAMDMedical Physician Assistant
0942NHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jun 1, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.