Jae Pulliam

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

100 Willow St
Lynn, MA 01901-1139

Phone

(781) 691-7060

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lynn Shelter Association

  • Case Management Agency
  • Lynn, MA
  • NPI 1619425196
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1801518451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011139",
            "telephone_number": "781-691-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011139",
            "telephone_number": "781-691-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "JAE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Psychiatric Associates of Lynn PC
• Psychiatric Group of the North Shore PC
• Psychiatric Partners of Essex County, LLC
• Estefany Alejandra Pujols, RN
• Rozanne Marie Puleo, FNP-BC
• Pulmonary Physicians
• Pyramid Builders Counseling Services, Inc
• Abdul Qudos
• Molly Quinion, MSW
• Lindsey Quinn, RN

• Case Manager/Care Coordinator in Lynn, MA
• Providers in Lynn, MA by specialty
• Case Manager/Care Coordinator in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.