Active NPI
Jill O. Dutra, PA-C
- Medical Physician Assistant
- Dover, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1291
- Practice address
- 770 Central Ave
Dover, NH 03820-3437 - Phone
- (603) 742-0101
- NPI assigned
- Aug 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1291 | NH | Primary |
Addresses
Primary practice location
770 Central Ave
Dover, NH 03820-3437
Mailing address
PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3110787 | Medicaid | NH |
Other names 1
- Jill Oliver
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Marketplace Blvd
Unit 9
Rochester, NH 03867-4387
Phone (603) 516-4212
789 Central Ave
Dover, NH 03820-2526
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wentworth Douglass Physician Corporation | Single Specialty | Current | Accepting new patients |
| Wentworth Douglass Hospital | Single Specialty | Current | Accepting new patients |
| Westchester Neurological Consultant PC | Single Specialty | Past | Accepting new patients |
Locations
8 Century Pines Dr
Ste 2
Barrington, NH 03825
Phone (603) 664-2135
789 Central Ave
Dover, NH 03820
Phone (603) 740-2832
65 Calef Hwy
Ste 200
Lee, NH 03861
Phone (603) 868-3300
67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092
150 Marketplace Blvd
Unit 9
Rochester, NH 03867
Phone (603) 516-4212
Interoperability endpoints
- oliver.jill.wdh@direct.partners.masshiway.net
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 4
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.
-
- Magnetic Resonance Imaging Radiologic Technologist
- Dover, NH
- NPI 1447352430
-
- General Acute Care Hospital
- Portsmouth, NH
- NPI 1528687829
Single Specialty
-
- Diagnostic Radiology Physician
- Somersworth, NH
- NPI 1295326494
Single Specialty
-
- Neurology Physician
- Yonkers, NY
- NPI 1114950136
Single Specialty
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dover, NH
- NPI 1033118104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1679098818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 412503",
"city": "BOSTON",
"state": "MA",
"postal_code": "022412503",
"telephone_number": "617-726-3884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 CENTRAL AVE",
"city": "DOVER",
"state": "NH",
"postal_code": "038203437",
"telephone_number": "603-742-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTRA",
"first_name": "JILL",
"middle_name": "O.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-09",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": "NH",
"license": "1291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3110787",
"state": "NH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "OLIVER",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.