Individual provider Active NPI

Jonathan Patrick Deweese, MSN, NP-C, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1497206817
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2291351 Issued in MA
Practice address
141 Western Ave Apt 1
Cambridge, MA 02139-3702
Phone
(517) 927-2831
NPI assigned
Oct 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2291351 MA Primary

Addresses

Primary practice location

141 Western Ave Apt 1
Cambridge, MA 02139-3702

Mailing address

141 Western Ave Apt 1
Cambridge, MA 02139-3702
Phone (617) 466-9083

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
I20180412002827 MA Practitioner - Nurse Practitioner 0244593853 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

141 Western Ave
Apt 1
Cambridge, MA 02139-3702
Phone (517) 927-2831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2291351MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Mar 7, 2018 Accepting new patients
Sagebrush Therapeutics, PLLC Psychiatric/Mental Health CurrentSince Feb 1, 2022 Accepting new patients
The General Hospital Corporation CurrentSince Mar 7, 2018 Accepting new patients
Cambridge Public Health Commission CurrentSince Aug 9, 2022 Accepting new patients
Cambridge Public Health Commission CurrentSince Aug 9, 2022 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1497206817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 WESTERN AVE APT 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393702",
            "telephone_number": "617-466-9083",
            "fax_number": "617-485-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 WESTERN AVE APT 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393702",
            "telephone_number": "517-927-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "JONATHAN",
        "middle_name": "PATRICK",
        "credential": "MSN, NP-C, PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-20",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2291351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.