Jennifer M. Boyle, FNP
Individual provider Active NPI Family Nurse Practitioner · Brookings, OR
NPI 1508802802 · NPPES record last updated Oct 21, 2010
Key facts
- NPI
- 1508802802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 200350054NP (OR)
- Practice address
- 585 5TH St
Brookings, OR 97415-9702 - Phone
- (541) 469-5377
- Fax
- (541) 469-8015
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1101 Chetco Ave
Brookings, OR 97415-2515
Phone (541) 254-9300
Hospital & facility affiliations
- Coastal Home Health & Hospice
- Curry General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060207000513 | OR | Practitioner - Nurse Practitioner | 0648285098 | Practice locations: Brookings, OR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Joseph Martinelli MD a Professional Corp | Past | Accepting new patients |
Interoperability endpoints
- jennifer.boyle.1@15569.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 200350054NP | OR | Yes |
Addresses
Primary practice location
585 5TH St
Brookings, OR 97415-9702
Mailing address
PO Box 6819
Brookings, OR 97415-0297
Phone (541) 469-5377
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 298898 | Medicaid | OR |
Other providers in Brookings, OR
- Ronald Dustin Bodman
- Shannon Bonde
- Charles Michael Bourland
- Ella Rose Bowron
- Marian L Boye
- Thomas Brand
- Steven T. Brantingham
- Kerstin Bravo
- Brice Chang Dentist PC
- Susan Elaine Brickley
All providers in Brookings, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.