Individual provider Active NPI

Jessica Dacius, CNP

  • Women's Health Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1679025258
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2299272 Issued in MA
Practice address
46 Obery St
Plymouth, MA 02360-2237
Phone
(508) 830-6116
NPI assigned
Oct 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2299272 MA
Women's Health Nurse Practitioner 363LW0102X 2299272 MA Primary

Addresses

Primary practice location

46 Obery St
Plymouth, MA 02360-2237

Mailing address

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 830-6116

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
I20190501002848 MA Practitioner - Nurse Practitioner 9739445941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

95 Tremont St
Duxbury, MA 02332-4738
Phone (781) 934-9532

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2299272MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince Jun 1, 2019 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Jun 1, 2019 Accepting new patients

Locations

95 Tremont St
Ste 5
Duxbury, MA 02332
Phone (781) 934-7292

83 Route 130
Forestdale, MA 02644
Phone (508) 827-1954

46 Obery St
Ste 2
Plymouth, MA 02360
Phone (508) 746-2345

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

Interoperability endpoints

  • Direct secure messaging: jdacius456542@direct.bilh.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.

Hospital & facility affiliations 1

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": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1679025258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-830-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-830-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACIUS",
        "first_name": "JESSICA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "2299272",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "2299272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.