NPIMap

Individual provider Active NPI

Jacqueline Marie Speed, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Salem, MA
National Provider Identifier
1811314966
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
License
A160406 Issued in CA
Practice address
400 Highland Ave
Salem, MA 01970-7003
Phone
(978) 741-4133
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X A160406 CA Primary

Addresses

Primary practice location

400 Highland Ave
Salem, MA 01970-7003

Mailing address

400 Highland Ave
Salem, MA 01970-7003
Phone (978) 741-4133

Other practice location 1

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Other names 1

  • Jacqueline Marie Havens Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624001421 MA Practitioner - Urology 3779700539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Columbia University College of Physicians and Surgeons, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

400 Highland Ave
Suite 6
Salem, MA 01970-1783
Phone (978) 741-4133

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A160406CAMDFemale Pelvic Medicine and Reconstructive Surgery (Urology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Nov 1, 2022 Accepting new patients
The General Hospital Corporation CurrentSince Nov 1, 2022 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Aug 1, 2021 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

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

55 Fruit St
Boston, MA 02114

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

104 Endicott St
Ste 303
Danvers, MA 01923
Phone (978) 524-0050

400 Highland Ave
Salem, MA 01970
Phone (781) 599-0220

400 Highland Ave
Ste 6
Salem, MA 01970
Phone (781) 599-0220

Interoperability endpoints

  • Direct secure messaging: speed.jacqueline.nsmc@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1811314966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019707003",
            "telephone_number": "978-741-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019707003",
            "telephone_number": "978-741-4133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEED",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "A160406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "HAVENS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.