Individual provider Active NPI

Jennifer Catherine Amon, CPNP

  • Pediatric Nurse Practitioner
  • Norwell, MA
National Provider Identifier
1679557987
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2299302 Issued in MA
Practice address
143 Longwater Dr
Norwell, MA 02061-1683
Phone
(781) 878-5200
NPI assigned
Nov 30, 2005
Last updated
Oct 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 300264 NC
Pediatric Nurse Practitioner 363LP0200X RN1008418 DC
Pediatric Nurse Practitioner 363LP0200X AP60023099 WA
Pediatric Nurse Practitioner 363LP0200X RN2299302 MA Primary
Pediatrics Physician 208000000X 300264 NC
Pediatric Adolescent Medicine Physician 2080A0000X 300264 NC

Addresses

Primary practice location

143 Longwater Dr
Norwell, MA 02061-1683

Mailing address

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

Other identifiers 6

IdentifierTypeStateIssuer
04-2297845OtherMULTI-PLAN
110102976AMedicaidMA
1679557987OtherFALLON
NP8062OtherMABCBSMA
04-2297845OtherTRICARE
1679557987OtherMANEIGHBORHOOD HEALTH PLAN

Other names 1

  • Jennifer Catherine Ostrander 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000543 MA Practitioner - Nurse Practitioner 2062513583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Pediatric Neurosurgical Foundation IncGroup PAC ID 2163491978, 10 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300264NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Pediatric Neurosurgical Foundation, Inc. Pediatrics CurrentSince Dec 18, 2018 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

Interoperability endpoints

  • Direct secure messaging: jamon33223@direct.bostonchildrens.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1679557987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 LONGWATER DR",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611683",
            "telephone_number": "781-878-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 LONGWATER DR",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611683",
            "telephone_number": "781-878-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMON",
        "first_name": "JENNIFER",
        "middle_name": "CATHERINE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300264",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN1008418",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60023099",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2299302",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "300264",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NC",
            "license": "300264",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-PLAN",
            "identifier": "04-2297845",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102976A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1679557987",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "NP8062",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "04-2297845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "1679557987",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "OSTRANDER",
            "middle_name": "CATHERINE",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.