Individual provider Active NPI

Jessica L Wisocky, APRN

  • Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1689007924
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2276918 Issued in MA
Practice address
500 Merrimack St
Lawrence, MA 01843-1981
Phone
(978) 557-8900
Fax
(978) 557-8859
NPI assigned
Aug 9, 2013
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 076676-23 NH
Family Nurse Practitioner 363LF0000X RN2276918 MA
Nurse Practitioner 363L00000X RN2276918 MA Primary

Addresses

Primary practice location

500 Merrimack St
Lawrence, MA 01843-1981

Mailing address

97 Central St Ste 303
Lowell, MA 01852-1931
Phone (978) 487-6783

Other identifiers 2

IdentifierTypeStateIssuer
1100980411AMedicaidMA
3111245MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140128001514 MA Practitioner - Nurse Practitioner 9335378017 Reassigns benefits to 3 organizations
I20180702000602 NH Practitioner - Nurse Practitioner 9335378017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

97 Central St
Suite 303
Lowell, MA 01852-1931
Phone (978) 487-6783

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince May 19, 2018 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Dec 11, 2013 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jun 1, 2021 Accepting new patients
Pathway to Better Health PLLC Family CurrentSince May 15, 2023 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Jun 1, 2021 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

97 Central St
Ste 303
Lowell, MA 01852
Phone (978) 309-5445

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

5 Washington Pl
Bedford, NH 03110
Phone (603) 314-4567

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 6

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1689007924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 CENTRAL ST STE 303",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521931",
            "telephone_number": "978-487-6783",
            "fax_number": "978-226-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431981",
            "telephone_number": "978-557-8900",
            "fax_number": "978-557-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOCKY",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "076676-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2276918",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2276918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1100980411A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3111245",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.