Individual provider Active NPI

Jennifer Lee Leavitt

  • Psychiatry Physician
  • Burlington, MA
National Provider Identifier
1619408390
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
286665 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-3464
Phone
(781) 744-8000
NPI assigned
Mar 23, 2017
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 286665 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-3464

Mailing address

101 Page St
New Bedford, MA 02740-3464

Other practice location 1

101 Page St
New Bedford, MA 02740-3464
Phone (973) 973-5865

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
I20210616001304 MA Practitioner - Psychiatry 0840690640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286665MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Feb 8, 2023 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Feb 8, 2023 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Northeast Hospital Corporation Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

Interoperability endpoints

  • Direct secure messaging: jleavitt197040@direct.bilh.masshiway.net
  • Direct secure messaging: jleavitt59084@direct.southcoast.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1619408390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PAGE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018053464",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Page St",
            "address_purpose": "LOCATION",
            "city": "New Bedford",
            "state": "MA",
            "postal_code": "027403464",
            "country_code": "US",
            "telephone_number": "973-973-5865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "286665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.