Jill T Kooyoomjian, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

274888 Issued in MA

Practice address

1 Essex Center Drive
Lahey Northshore
Peabody, MA 01960-4711

Phone

(978) 538-4370

Fax

(978) 538-4708

NPI assigned

Oct 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
• Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  Care Compare affiliation
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  Care Compare affiliation

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1821240177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DR.",
            "address_2": "LAHEY CLINIC",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "781-674-1587",
            "fax_number": "781-674-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DRIVE",
            "address_2": "LAHEY NORTHSHORE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604711",
            "telephone_number": "978-538-4370",
            "fax_number": "978-538-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOYOOMJIAN",
        "first_name": "JILL",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "274888",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN274888",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MA",
            "license": "274888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110080842A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Anton Kobus, PT, DPT
• Brianna L Kodis, MS CCC-SLP
• Susan Koenig, PT
• Yanping Kong, M.D.
• Mridul Kontamwar
• Amy Korenman
• Kevin M. Koshy, MD
• Emily Kossowsky, LMHC
• Gurmeet Kour, D.M.D.
• Thea Koutoulas

• Obstetrics & Gynecology Nurse Practitioner in Peabody, MA
• Providers in Peabody, MA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.