Individual provider Active NPI

Jessica Rose Dipietrantonio

  • Physician Assistant
  • Cambridge, MA
National Provider Identifier
1659072148
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA100517 Issued in MA
Practice address
1493 Cambridge St
Cambridge, MA 02139-1099
Phone
(617) 665-1000
NPI assigned
Mar 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA100517 MA Primary

Addresses

Primary practice location

1493 Cambridge St
Cambridge, MA 02139-1099

Mailing address

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1000

Other practice location 1

136 Harrison Ave
Boston, MA 02111-1817
Phone (617) 636-7000

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
I20240404003424 MA Practitioner - Physician Assistant 5698113942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA100517MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince May 5, 2024 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients

Locations

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

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

230 Highland Ave
Somerville, MA 02143
Phone (617) 591-4350

Interoperability endpoints

  • Direct secure messaging: jphinney120876@direct.challiance.masshiway.net

Organizations & group practices 2

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": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1659072148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391099",
            "telephone_number": "617-665-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111817",
            "country_code": "US",
            "telephone_number": "617-636-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIPIETRANTONIO",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.