Individual provider Active NPI

Jamie Tenneill Isaac Jefferson, CNP

  • Women's Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1902267727
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN2292515 Issued in MA
Practice address
330 Brookline Ave
Bidmc, Department of OB/GYN, Shapiro 8TH Floor
Boston, MA 02215-5400
Phone
(617) 667-3736
Fax
(617) 667-7493
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN2292515 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Bidmc, Department of OB/GYN, Shapiro 8TH Floor
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Bidmc, Department of OB/GYN, Shapiro 8TH Floor
Boston, MA 02215-5400
Phone (617) 667-3736

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
I20160510000510 MA Practitioner - Nurse Practitioner 4082903398 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2292515MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 20, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Feb 20, 2016 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Feb 20, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 20, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
Fl 8
Boston, MA 02215
Phone (617) 667-3736

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: jisaacjefferson255540@direct.bilh.masshiway.net

Organizations & group practices 6

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 1

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1902267727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BIDMC, DEPARTMENT OF OB/GYN, SHAPIRO 8TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3736",
            "fax_number": "617-667-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BIDMC, DEPARTMENT OF OB/GYN, SHAPIRO 8TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3736",
            "fax_number": "617-667-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAAC JEFFERSON",
        "first_name": "JAMIE",
        "middle_name": "TENNEILL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2292515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.