Jill Marie Collins, PA-C

Key facts

NPI

1780184143

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

PA6437 (MA)

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 334-3850

NPI assigned

Feb 12, 2018

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Umass Memorial Medical Group Inc Internal Medicine Physician · Worcester, MA · NPI 1760445373
  Medicare reassignment NPD MA · PHYSICIAN ASSISTANT
• Brigham & Womens Physicians Organization Inc Internal Medicine Physician · Boston, MA · NPI 1033535497
  Medicare reassignment MA
• Umass Memorial Medical Group, Inc. Urgent Care Clinic/Center · Oxford, MA · NPI 1982381018
  NPD
• Lifespan Physician Group, Inc. General Practice Physician · Providence, RI · NPI 1407116643
  NPD
• Lifespan Physician Group, Inc. Emergency Medicine Physician · Providence, RI · NPI 1568325678
  NPD PHYSICIAN ASSISTANT
• Rhode Island Hospital Multi-Specialty Clinic/Center · Providence, RI · NPI 1154537520
  NPD
• Rhode Island Hospital General Acute Care Hospital · Providence, RI · NPI 1972768174
  NPD
• Lifespan Physician Group, Inc. Psychiatry Physician · Providence, RI · NPI 1548506793
  NPD (past)
• Rhode Island Hospital General Acute Care Hospital · Providence, RI · NPI 1588659528
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Jill Marie Goretti Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 19, 2024.

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1780184143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41538",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA01120",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6437",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6437",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "GORETTI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

• Dina Ashley Collins, MD
• Erin Davis Collins, R.N.
• Estelle Collins
• Frederick Boateng Collins
• Harrison Collins, CLINICIAN
• Kailey Collins
• Katherine Collins
• Lee Ann Powers Collins, PCNS
• Matthew J Collins, M.D.
• Megan V. Collins, CRNA

All providers in Worcester, MA · Physician Assistant in Massachusetts