NPIMap

Individual provider Active NPI

Jessica Anne Charles-Larose, MD

  • Family Medicine Physician
  • Bedford, NH
National Provider Identifier
1861021784
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33679 Issued in NH
Practice address
25 Leavy Dr
Bedford, NH 03110
Phone
(603) 472-7233
NPI assigned
Apr 2, 2020
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 64272 NU
Student in an Organized Health Care Education/Training Program 390200000X EC221041 ME
Acupuncturist 171100000X 33679 NH
Family Medicine Physician 207Q00000X 33679 NH Primary

Addresses

Primary practice location

25 Leavy Dr
Bedford, NH 03110

Mailing address

6 White Oak LN
Derry, NH 03038-7268
Phone (781) 267-4148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20241010002112 NH Practitioner - Family Practice 8729465331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

25 Leavey Dr
Bedford, NH 03110-4437
Phone (603) 472-7233

275 Mammoth Rd
Manchester, NH 03109-4133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
87.58
Promoting interoperability
99.38
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Elliot Hospital of the City of Manchester PastSince Sep 15, 2024 Accepting new patients

Locations

25 Leavey Dr
Bedford, NH 03110
Phone (603) 472-5860

25 Leavey Dr
Ste 105
Bedford, NH 03110

25 Leavey Dr
Unit 1
Bedford, NH 03110

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

Interoperability endpoints

  • Direct secure messaging: jcharleslarose169212@direct.solutionhealth.org
  • Direct secure messaging: jcharleslarose789480@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1861021784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WHITE OAK LN",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030387268",
            "telephone_number": "781-267-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LEAVY DR",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "03110",
            "telephone_number": "603-472-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES-LAROSE",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": "64272",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": "EC221041",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NH",
            "license": "33679",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "33679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.