Jacqueline Elyse Marong, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN2284774 Issued in MA

Practice address

92 Montvale Ave Ste 4200
Stoneham, MA 02180-3655

Phone

(781) 451-0072

NPI assigned

May 23, 2013

Last updated

Mar 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Elyse Daigle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jdaigle14906@direct.chppoc.masshiway.net

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1750728226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 4200",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803655",
            "telephone_number": "781-451-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 4200",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803655",
            "telephone_number": "781-451-0072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Gables Cir",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019701217",
            "country_code": "US",
            "telephone_number": "978-335-3504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARONG",
        "first_name": "JACQUELINE",
        "middle_name": "ELYSE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2284774",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2284774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "DAIGLE",
            "middle_name": "ELYSE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Manferdini, LICSW
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• Mary L Marino, HA179
• Andrew Joseph Mastrangelo, PT, DPT, NREMT
• Chantal Dolly McCarron, O.D.
• Paul Glen McCormick, PH.D.
• Matthew J McDonald, PA-C
• Patricia McGinnis

• Pediatric Nurse Practitioner in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.