Individual provider Active NPI

Jessica Lynn Robertson, NP

  • Family Nurse Practitioner
  • Pembroke, MA
National Provider Identifier
1922578467
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2267880 Issued in MA
Practice address
295 Old Oak St
Pembroke, MA 02359-1955
Phone
(508) 210-5964
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2267880 MA Primary

Addresses

Primary practice location

295 Old Oak St
Pembroke, MA 02359-1955

Mailing address

464 Hillside Ave Ste 304
Needham, MA 02494-1228
Phone (617) 754-0562

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
I20190305003129 MA Practitioner - Nurse Practitioner 0941549109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

95 Tremont St
Suite 10
Duxbury, MA 02332-4738
Phone (781) 934-0060

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Falmouth Hospital Hospital, Falmouth, MA, CCN 220135
  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
  • Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2267880MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation CurrentSince Jan 12, 2019 Accepting new patients

Locations

95 Tremont St
Ste 10
Duxbury, MA 02332
Phone (781) 934-0060

464 Hillside Ave
Ste 304
Needham, MA 02494
Phone (617) 754-0549

295 Old Oak St
Pembroke, MA 02359
Phone (508) 210-5964

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: jrobertson251818@direct.bilh.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 4

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1922578467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 HILLSIDE AVE STE 304",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941228",
            "telephone_number": "617-754-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 OLD OAK ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591955",
            "telephone_number": "508-210-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2267880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

Verify at the official NPI Registry.