Individual provider Active NPI

Jennifer Jackson McCabe, NP

  • Family Nurse Practitioner
  • Weston, MA
National Provider Identifier
1689792962
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
168723 Issued in MA
Practice address
29 Deer Path LN
Weston, MA 02493-1139
Phone
(781) 642-1912
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 168723 MA Primary

Addresses

Primary practice location

29 Deer Path LN
Weston, MA 02493-1139

Mailing address

10 Thaddeus Mason Rd
Northborough, MA 01532-2284
Phone (617) 209-7823

Other identifiers 1

IdentifierTypeStateIssuer
CK9228OtherMARAILROAD MEDICARE

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
I20040503000082 MA Practitioner - Nurse Practitioner 8426046236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ajay Anand MD PCGroup PAC ID 3971591900, 4 clinicians

Practice addresses (Care Compare)

29 Deer Path LN
Weston, MA 02493-1139
Phone (781) 642-1912

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168723MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ajay Anand MD PC PastSince Aug 27, 2018 Accepting new patients
Mikhail Novikov MD Past Accepting new patients

Organizations & group practices 3

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1689792962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 THADDEUS MASON RD",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322284",
            "telephone_number": "617-209-7823",
            "fax_number": "617-336-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 DEER PATH LN",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931139",
            "telephone_number": "781-642-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "JENNIFER",
        "middle_name": "JACKSON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "168723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK9228",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, MA

Sources for this page

Verify at the official NPI Registry.