Individual provider Active NPI

Jennifer Poillucci, CNP, FNP-C

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1467836254
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN04386 Issued in RI
Practice address
345 Blackstone Blvd
Providence, RI 02906-4800
Phone
(401) 680-6502
Fax
(401) 455-6309
NPI assigned
Jul 13, 2015
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN216727 MA
Family Nurse Practitioner 363LF0000X APRN04386 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd
Providence, RI 02906-4800

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 273-0641

Other practice location 1

266 Route 44
Raynham, MA 02767-1403
Phone (866) 389-2727

Other practice location 2

72 Washington St
Taunton, MA 02780-2491
Phone (508) 828-7000

Other practice location 3

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Other practice location 4

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160428002120 MA Practitioner - Nurse Practitioner 5991004780 Reassigns benefits to 5 organizations
I20251009001322 RI Practitioner - Nurse Practitioner 5991004780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians
Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

455 Tollgate Rd
Warwick, RI 02886-2759

88 Washington St
Taunton, MA 02780-2465
Phone (508) 828-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Oct 26, 2025 Accepting new patients
Sound Physicians of Massachusetts, Inc CurrentSince Sep 1, 2016 Accepting new patients
Affinity Physicians LLC. CurrentSince Oct 26, 2025 Accepting new patients
Lifespan Physician Group of Massachusetts Inc CurrentSince Jan 1, 2025 Accepting new patients
Sound Physicians of Massachusetts, Inc CurrentSince Sep 1, 2016 Accepting new patients
Sound Physicians of Massachusetts II PC CurrentSince Nov 15, 2017 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 31, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 31, 2019 Accepting new patients
Sound Physicians of Massachusetts Inc Current Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6200

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 9

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 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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1467836254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-680-6502",
            "fax_number": "401-455-6309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "266 Route 44",
            "address_purpose": "LOCATION",
            "city": "Raynham",
            "state": "MA",
            "postal_code": "027671403",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 Washington St",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027802491",
            "country_code": "US",
            "telephone_number": "508-828-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "88 Washington St",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "02780",
            "country_code": "US",
            "telephone_number": "508-828-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POILLUCCI",
        "first_name": "JENNIFER",
        "credential": "CNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN216727",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN04386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.