Individual provider Active NPI

Jackson Dean Lindsay, PA, ATC

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1942571393
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 732-5500
NPI assigned
Jan 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2142 MA
Physician Assistant 363A00000X MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

14 Corinthian Rd
Somerville, MA 02144-1810

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
I20191125002578 MA Practitioner - Physician Assistant 3173956596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2142MAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • Direct secure messaging: lindsay.jackson.bwh@direct.partners.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.

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1942571393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CORINTHIAN RD",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "JACKSON",
        "middle_name": "DEAN",
        "credential": "PA, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2142",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.