Individual provider Active NPI

Kristin Jennifer Hennessey, FNP

  • Family Nurse Practitioner
  • Dorchester, MA
National Provider Identifier
1851643969
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2282063 Issued in MA
Practice address
398 Neponset Ave
Dorchester, MA 02122-3134
Phone
(617) 282-3200
Fax
(617) 282-8201
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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 RN2282063 MA
Family Nurse Practitioner 363LF0000X 2282063 MA Primary

Addresses

Primary practice location

398 Neponset Ave
Dorchester, MA 02122-3134

Mailing address

1135 Morton St
Mattapan, MA 02126-2834
Phone (617) 533-2300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151104002612 MA Practitioner - Nurse Practitioner 8123338001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1021 Main St
Suite 203
Winchester, MA 01890-1446

161 Jackson St
Lowell, MA 01852-2103

41 Mall Rd
Burlington, MA 01805-0001

701 Edgewater Dr
Suite 420
Wakefield, MA 01880-6243

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2282063MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Physician Associates, Inc CurrentSince Dec 1, 2018 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

1021 Main St
Ste 1
Winchester, MA 01890
Phone (781) 729-1021

Interoperability endpoints

  • Direct secure messaging: khennessey113803@direct.bilh.masshiway.net

Organizations & group practices 2

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 2

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": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1851643969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-533-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 NEPONSET AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223134",
            "telephone_number": "617-282-3200",
            "fax_number": "617-282-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "KRISTIN",
        "middle_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2282063",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2282063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.