Individual provider Active NPI

Jaymie Adachi, FNP

  • Family Nurse Practitioner
  • Harwich Port, MA
National Provider Identifier
1780082180
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2322504 Issued in MA
Practice address
710 Route 28
Harwich Port, MA 02646-1931
Phone
(508) 432-1400
NPI assigned
Dec 17, 2014
Last updated
May 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339291 NY
Family Nurse Practitioner 363LF0000X 2322504 MA Primary

Addresses

Primary practice location

710 Route 28
Harwich Port, MA 02646-1931

Mailing address

13 Deer Meadow Rd
Harwich, MA 02645-2223
Phone (917) 796-5792

Other practice location 1

9704 Sutphin Blvd
Jamaica, NY 11435-4721
Phone (718) 657-7088

Other identifiers 2

IdentifierTypeStateIssuer
00695941MedicaidNY
04075292MedicaidNY

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
I20180913000877 MA Practitioner - Nurse Practitioner 6507183399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Gynecology, LLCGroup PAC ID 2062455397, 2 clinicians

Practice addresses (Care Compare)

19 Bay State Court
Brewster, MA 02631-2120
Phone (508) 255-2325

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
339291NYMDRegistered Nurse
2322504MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Cape Health Services, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Outer Cape Health Services, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Cape Gynecology, LLC CurrentSince Jan 1, 2026 Accepting new patients
Outer Cape Health Services Past Accepting new patients

Locations

19 Bay State Ct
Brewster, MA 02631
Phone (508) 255-2325

49 Harry Kemp Way
Provincetown, MA 02657
Phone (508) 487-9395

3130 State Hwy Rte 6
Wellfleet, MA 02667
Phone (508) 349-3131

Interoperability endpoints

  • Direct secure messaging: jadachi367725@direct.ochin.org

Organizations & group practices 4

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 2

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": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1780082180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DEER MEADOW RD",
            "city": "HARWICH",
            "state": "MA",
            "postal_code": "026452223",
            "telephone_number": "917-796-5792",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ROUTE 28",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "026461931",
            "telephone_number": "508-432-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9704 Sutphin Blvd",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114354721",
            "country_code": "US",
            "telephone_number": "718-657-7088",
            "fax_number": "718-657-7092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADACHI",
        "first_name": "JAYMIE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339291",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2322504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04075292",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harwich Port, MA

Sources for this page

Verify at the official NPI Registry.