Jelena Ivanis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1013825 Issued in MA

Practice address

10 Centennial Drive
Peabody, MA 01960

Phone

(978) 535-1110

Fax

(978) 535-2907

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jivanis37250@direct.chppoc.masshiway.net

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.

• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  NPD (past)
• Pediatric Health Care Associates PC

  • Pediatrics Physician
  • Peabody, MA
  • NPI 1821153180
  NPD (past)

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1831718683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DRIVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DRIVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANIS",
        "first_name": "JELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1013825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "4650 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Internal Medicine Physicians of the North Shore LLC
• Callie Kristine Intonti, RN
• Cafer Irmak
• Jennifer Isaac
• It'S Catherine'S Adult Day Care
• Stephanie Jacob, LICSW
• Jamie Jacobsen, LCSW
• Mitchell Scott Jacobson, M.D.
• Nirmal Parshad Jain, MD
• Kristopher James, LMSW

• Pediatrics Physician in Peabody, MA
• Providers in Peabody, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.