Individual provider Active NPI

Jill A. T. Duchesne

  • Certified Registered Nurse Anesthetist
  • Concord, MA
National Provider Identifier
1801274782
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN253292 Issued in MA
Practice address
133 Ornac
Concord, MA 01742-4159
Phone
(987) 287-1400
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 253292 MA
Certified Registered Nurse Anesthetist 367500000X RN253292 MA Primary

Addresses

Primary practice location

133 Ornac
Concord, MA 01742-4159

Mailing address

196 Proctor Rd
Chelmsford, MA 01824-4433

Other names 1

  • Jill A. Tereshko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925002410 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234447152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates II, IncGroup PAC ID 4183765191, 50 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-8480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253292MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates II, Inc. CurrentSince Sep 30, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Jan 27, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 27, 2022 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

Organizations & group practices 3

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.

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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1801274782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PROCTOR RD",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018244433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ORNAC",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159",
            "telephone_number": "987-287-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCHESNE",
        "first_name": "JILL",
        "middle_name": "A. T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "253292",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN253292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "TERESHKO",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.