Individual provider Active NPI

Jessica E Haffner, ACNP-BC

  • Registered Nurse
  • Belmont, MA
National Provider Identifier
1922476688
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2270303 Issued in MA
Practice address
36 Stewart Ter
Belmont, MA 02478-3956
Phone
(617) 697-1917
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 064299-21 NH
Registered Nurse 163W00000X 642900 NY
Registered Nurse 163W00000X RN2270303 MA Primary
Acute Care Nurse Practitioner 363LA2100X RN2270301 MA

Addresses

Primary practice location

36 Stewart Ter
Belmont, MA 02478-3956

Mailing address

36 Stewart Ter
Belmont, MA 02478-3956
Phone (617) 484-7173

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
I20210512002253 MA Practitioner - Nurse Practitioner 6901215433 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2270303MAMDRegistered Nurse
064299-21NHMDRegistered Nurse
642900NYMDRegistered Nurse
RN2270301MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Current Accepting new patients
Pratt Medical Group, Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1922476688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 STEWART TER",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783956",
            "telephone_number": "617-484-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 STEWART TER",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783956",
            "telephone_number": "617-697-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFFNER",
        "first_name": "JESSICA",
        "middle_name": "E",
        "credential": "ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "064299-21",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "642900",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2270303",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2270301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.