Individual provider Active NPI

Tara Marion Jean, MSN-FNP-C

  • Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1922704790
Registry record updated Apr 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
284299 Issued in MA
Practice address
161 Jackson St
Lowell, MA 01852-2103
Phone
(978) 937-9700
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 284299 MA
Nurse Practitioner 363L00000X 284299 MA Primary

Addresses

Primary practice location

161 Jackson St
Lowell, MA 01852-2103

Mailing address

42 Coral Dr
Dracut, MA 01826-1680
Phone (781) 454-5451

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
I20240403001392 MA Practitioner - Nurse Practitioner 2961840467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle Health Urgent Care LLCGroup PAC ID 4486976792, 39 clinicians

Practice addresses (Care Compare)

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

198 Littleton Rd
Suite 101
Westford, MA 01886-3429
Phone (978) 323-0302

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Feb 24, 2024 Accepting new patients
Circle Health Urgent Care, LLC CurrentSince Feb 16, 2026 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Feb 24, 2024 Accepting new patients

Locations

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

198 Littleton Rd
Ste 101
Westford, MA 01886
Phone (978) 323-0302

Interoperability endpoints

  • Direct secure messaging: tjean45494@direct.ctc.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 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": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680307200000",
    "number": "1922704790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CORAL DR",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018261680",
            "telephone_number": "781-454-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103",
            "telephone_number": "978-937-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "TARA",
        "middle_name": "MARION",
        "credential": "MSN-FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-04-01",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "284299",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "284299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.