NPIMap

Individual provider Active NPI

Jessica Danielle Stevenson, M.D.

  • Family Medicine Physician
  • Malden, MA
National Provider Identifier
1912266982
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
264423 Issued in MA
Practice address
178 Savin St
Suite 100
Malden, MA 02148-2329
Phone
(781) 338-7400
NPI assigned
May 11, 2012
Last updated
Sep 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 264423 MA Primary

Addresses

Primary practice location

178 Savin St
Suite 100
Malden, MA 02148-2329

Mailing address

178 Savin St
Suite 100
Malden, MA 02148-2329
Phone (781) 338-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150923003059 MA Practitioner - Family Practice 6103133178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1350 Market St
Lynnfield, MA 01940-4048
Phone (781) 213-4050

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264423MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Oct 1, 2018 Accepting new patients
Hallmark Health Medical Associates Inc Family Medicine CurrentSince Jul 17, 2015 Accepting new patients

Locations

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jstevenson103556@direct.bilh.masshiway.net

Organizations & group practices 3

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 8

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1912266982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 SAVIN ST",
            "address_2": "SUITE 100",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021482329",
            "telephone_number": "781-338-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 SAVIN ST",
            "address_2": "SUITE 100",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021482329",
            "telephone_number": "781-338-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "264423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.