Individual provider Active NPI

Gianna Jimenez, PA

  • Physician Assistant
  • Dedham, MA
National Provider Identifier
1508355702
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6546 Issued in MA
Practice address
719 Providence Hwy
Dedham, MA 02026-6832
Phone
(508) 771-8350
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA6546 MA Primary

Addresses

Primary practice location

719 Providence Hwy
Dedham, MA 02026-6832

Mailing address

PO Box 716
West Barnstable, MA 02668-0716
Phone (774) 994-2861

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
I20180725001154 MA Practitioner - Physician Assistant 7315294196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. Pediatrics CurrentSince Jun 11, 2018 Accepting new patients
PM Pediatrics of Bayside PLLC Past Accepting new patients
PM Pediatrics PC Pediatrics Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics of New England LLC Pediatrics Past Accepting new patients
PM Pediatrics of New England LLC Pediatrics Past Accepting new patients
PM Pediatrics of New England LLC Pediatrics Past Accepting new patients
PM Pediatrics of New England LLC Past Accepting new patients

Locations

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

150 Ansel Hallet Rd
West Yarmouth, MA 02673
Phone (508) 771-8350

Organizations & group practices 8

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1508355702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "city": "WEST BARNSTABLE",
            "state": "MA",
            "postal_code": "026680716",
            "telephone_number": "774-994-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 PROVIDENCE HWY",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266832",
            "telephone_number": "508-771-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "GIANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.