Individual provider Active NPI

Jessie H Macvicar, MD

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1912988874
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
206882 Issued in MA
Practice address
1 Pearl St
Suite 2000
Brockton, MA 02301
Phone
(508) 584-4104
Fax
(508) 584-2053
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 206882 MA Primary

Addresses

Primary practice location

1 Pearl St
Suite 2000
Brockton, MA 02301

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

15 Roche Brothers Way
Suite 210
North Easton, MA 02356
Phone (781) 297-8001

Other practice location 2

736 Cambridge St.
Brighton, MA 02135
Phone (617) 789-2442

Other identifiers 2

IdentifierTypeStateIssuer
110005045AMedicaidMA
0161730MedicaidMA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000905 MA Practitioner - General Surgery 4385713999

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521

720 Harrison Ave
Boston, MA 02118-2376

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

960 Massachusetts Ave
Suite 2
Boston, MA 02118-2620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy37
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Surgery CurrentSince Oct 1, 2013 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

110 Liberty St
Ste 2A
Brockton, MA 02301
Phone (508) 894-0766

1 Pearl St
Brockton, MA 02301
Phone (508) 586-3600

1 Pearl St
Ste 2000
Brockton, MA 02301
Phone (508) 584-4104

110 Liberty St
Brockton, MA 02301

Interoperability endpoints

  • Direct secure messaging: jessie.macvicar@direct.signature.masshiway.net

Organizations & group practices 1

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1912988874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 2000",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-584-4104",
            "fax_number": "508-584-2053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Roche Brothers Way",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "North Easton",
            "state": "MA",
            "postal_code": "02356",
            "country_code": "US",
            "telephone_number": "781-297-8001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "736 Cambridge St.",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "02135",
            "country_code": "US",
            "telephone_number": "617-789-2442",
            "fax_number": "617-202-4349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACVICAR",
        "first_name": "JESSIE",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "206882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110005045A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161730",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.