Individual provider Active NPI

Jentina Mitchell, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1447771829
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2306688 Issued in MA
Practice address
20 Central Ave
Lynn, MA 01901-1201
Phone
(781) 477-7222
NPI assigned
Jul 6, 2017
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2306688 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2306688 MA Primary
Registered Nurse 163W00000X RN2306688 MA

Addresses

Primary practice location

20 Central Ave
Lynn, MA 01901-1201

Mailing address

269 Union St
Lynn, MA 01901-1314
Phone (781) 780-4555

Other practice location 1

55 Fruit St
Boston, MA 02114
Phone (415) 548-0471

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
I20171012002496 MA Practitioner - Nurse Practitioner 5799050084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2306688MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Sep 25, 2017 Accepting new patients
The General Hospital Corporation CurrentSince Apr 13, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 13, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

20 Central Ave
Lynn, MA 01901
Phone (781) 477-7222

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

Interoperability endpoints

  • Direct secure messaging: mitchell.jentina.mgh@direct.partners.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.

Hospital & facility affiliations 1

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1447771829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-780-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTRAL AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011201",
            "telephone_number": "781-477-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "415-548-0471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JENTINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2306688",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2306688",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2306688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.