Individual provider Active NPI

Jennifer Rebecca Stevens, CNM

  • Advanced Practice Midwife
  • Boston, MA
National Provider Identifier
1760480487
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN2307765 Issued in MA
Practice address
725 Albany St, FL 5
Boston, MA 02118
Phone
(617) 414-2000
Fax
(617) 414-5798
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN2307765 MA Primary

Addresses

Primary practice location

725 Albany St, FL 5
Boston, MA 02118

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other names 1

  • Jennifer R Roehl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120726000188 PA Practitioner - Certified Nurse Midwife (CNM) 4183880776 Reassigns benefits to 1 organization
I20230616002730 MA Practitioner - Certified Nurse Midwife (CNM) 4183880776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN2307765MAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince May 1, 2025 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince May 1, 2025 Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

2160 State Rd
Ste 1820
Lancaster, PA 17601
Phone (223) 287-8160

Organizations & group practices 5

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1760480487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST, FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2307765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROEHL",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.