Jennifer Shannon Patoulidis, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA4082 Issued in MA

Practice address

800 Washington St
Neurology Dept
Boston, MA 02111-1552

Phone

(617) 636-8488

NPI assigned

Nov 17, 2010

Last updated

Aug 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New England Medical Center Group Practice IncGroup PAC ID 4789647405, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tufts Medical Center Hospital, Boston, MA, CCN 220116
• Lowell General Hospital Hospital, Lowell, MA, CCN 220063

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jpatoulidis29733@tuftsmedicine.direct-ci.com

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.

• New England Medical Center Group Practice Inc

  dba Pratt Neurosurgical Associates, Inc

  • Neurological Surgery Physician
  • Boston, MA
  • NPI 1487601787
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Lowell General Hospital

  dba Lowell General Hospital

  • General Acute Care Hospital
  • Lowell, MA
  • NPI 1407804669
  Care Compare affiliation
• Tufts Medical Center, Inc.

  dba Tufts Medical Center

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1689976011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 KENMERE RD",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "NEUROLOGY DEPT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATOULIDIS",
        "first_name": "JENNIFER",
        "middle_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amrit Patnaik
• Pooja Patnaik
• Casey Patnode
• Alichia Louise Paton, ACNP
• Erica Paton, MS, RDN, LDN
• Patricia Paisley (Pcpextraordinary Home Care)
• David A Patrick Jr., MD
• Heather Patrick, FNP
• Lucas Patrick, DMD
• William Fernando Macdonald Patrick

• Medical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.

Verify at the official NPI Registry.