Individual provider Active NPI

Jennifer Hall Difalco, M.D.

  • Family Medicine Physician
  • Brockton, MA
National Provider Identifier
1558636373
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
79433 Issued in MA
Practice address
111 Torrey St
Brockton, MA 02301-4800
Phone
(508) 588-1200
NPI assigned
Mar 12, 2012
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 79433 MA Primary

Addresses

Primary practice location

111 Torrey St
Brockton, MA 02301-4800

Mailing address

111 Torrey St
Brockton, MA 02301-4800
Phone (508) 588-1200

Other names 1

  • Dr. Jennifer Alice Hall Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000170 MA Practitioner - Family Practice 1355594243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bethel Medical Group PCGroup PAC ID 4688576721, 5 clinicians

Practice addresses (Care Compare)

111 Torrey St
Brockton, MA 02301-4800
Phone (508) 588-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bethel Medical Group PC Family Medicine CurrentSince Nov 1, 2012 Accepting new patients

Locations

111 Torrey St
Brockton, MA 02301
Phone (508) 584-5190

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/111/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.hall.difalco.1@111.direct.athenahealth.com

Organizations & group practices 1

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": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1558636373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014800",
            "telephone_number": "508-588-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014800",
            "telephone_number": "508-588-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFALCO",
        "first_name": "JENNIFER",
        "middle_name": "HALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "79433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HALL",
            "middle_name": "ALICE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.