Individual provider Active NPI

Jaleh Rasoli

  • Medical Physician Assistant
  • Wellesley, MA
National Provider Identifier
1740792530
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6297 Issued in MA
Practice address
20 Hickory Rd
Wellesley, MA 02482-4534
Phone
(617) 721-0886
NPI assigned
Nov 1, 2017
Last updated
Nov 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6297 MA Primary

Addresses

Primary practice location

20 Hickory Rd
Wellesley, MA 02482-4534

Mailing address

20 Hickory Rd
Wellesley, MA 02482-4534
Phone (617) 721-0886

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
I20180320001614 MA Practitioner - Physician Assistant 9335401967 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowell General Inpatient Specialists PLLCGroup PAC ID 8729371380, 70 clinicians
Winchester Lahey Inpatient Specialists PLLCGroup PAC ID 6608150149, 30 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6439

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 729-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6297MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England PC CurrentSince Feb 1, 2018 Accepting new patients
Ipc Hospitalists of New England, P.C. Medical CurrentSince Feb 1, 2018 Accepting new patients
Winchester Hospital Past Accepting new patients

Locations

95 Commercial St
Braintree, MA 02184
Phone (781) 848-0596

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

37 Route 6A
Sandwich, MA 02563
Phone (508) 888-8222

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1740792530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HICKORY RD",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024824534",
            "telephone_number": "617-721-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HICKORY RD",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024824534",
            "telephone_number": "617-721-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASOLI",
        "first_name": "JALEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "6297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.