Jessica Kolczewski, MSN, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

283466 Issued in MA

Practice address

1093 N. Main St.
Randolph, MA 02368

Phone

(781) 963-7775

Fax

(781) 963-7776

NPI assigned

Jan 23, 2015

Sex

Female

Sole proprietor

Yes

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

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeastern Psychiatric AssocGroup PAC ID 4486696614, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Southeastern Psychiatric Assoc

  • Psychiatry Physician
  • Randolph, MA
  • NPI 1891771267
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1740670124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 N. MAIN ST.",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 N. MAIN ST.",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLCZEWSKI",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "283466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rohini Khouri-Babulal
• Angela Kigathi
• Stephen P Kilgus, MA
• Debra Klezmer, LMT,RN,C,CRRN
• Mark S Klezmer, DC
• Mary Jane Krupa-Foy, MASSAGE THERAPIST
• Afriyie Kusi
• Maren Kuttimalai
• Nana Akomaa Kyerematen, M.S.
• L&L Healthcare Staffing Solution LLC

• Psychiatric/Mental Health Nurse Practitioner in Randolph, MA
• Providers in Randolph, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.