Individual provider Active NPI

Jessica R Poulin, M.D.

  • Maternal & Fetal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1972896694
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
ME119737 Issued in FL
Practice address
2979 Pga Blvd Ste 100
Palm Beach Gardens, FL 33410
Phone
(561) 626-3800
Fax
(561) 624-6364
NPI assigned
May 27, 2011
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X TRN15983 FL
Maternal & Fetal Medicine Physician 207VM0101X ME119737 FL Primary

Addresses

Primary practice location

2979 Pga Blvd Ste 100
Palm Beach Gardens, FL 33410

Mailing address

770 Northpoint Pkwy Ste 102
West Palm Beach, FL 33407-1901
Phone (561) 275-7604

Other identifiers 1

IdentifierTypeStateIssuer
015052200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, WY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150717001784 FL Practitioner - Obstetrics/Gynecology 9830402999 Reassigns benefits to 2 organizations
I20231114000458 AL Practitioner - Obstetrics/Gynecology 9830402999 Reassigns benefits to 1 organization
I20241010003469 WY Practitioner - Obstetrics/Gynecology 9830402999 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN15983FLMDObstetrics & Gynecology Physician
ME119737FLMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 1, 2023 Accepting new patients
North Lincoln County Hospital District Current Accepting new patients
Critical Perinatal Solutions P.C. Maternal & Fetal Medicine CurrentSince Mar 4, 2025 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 1, 2023 Accepting new patients
North Lincoln County Hospital District CurrentSince Sep 1, 2024 Accepting new patients
FWC Perinatal, LLC Maternal & Fetal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

345 Jupiter Lakes Blvd
Ste 200
Jupiter, FL 33458
Phone (561) 741-1957

3900 E Indiantown Rd
Jupiter, FL 33477
Phone (307) 205-3084

2979 Pga Blvd
Ste 100
Palm Beach Gardens, FL 33410
Phone (561) 627-6801

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1447 Medical Park Blvd
Ste 300
Wellington, FL 33414
Phone (561) 790-5990

770 Northpoint Pkwy
Ste 200
West Palm Beach, FL 33407
Phone (561) 555-3331

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

514 E Grand Ave
Laramie, WY 82070

Interoperability endpoints

  • Direct secure messaging: jessica.poulin.1@29361.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1972896694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 NORTHPOINT PKWY STE 102",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071901",
            "telephone_number": "561-275-7604",
            "fax_number": "561-802-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 PGA BLVD STE 100",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-626-3800",
            "fax_number": "561-624-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIN",
        "first_name": "JESSICA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "TRN15983",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "FL",
            "license": "ME119737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015052200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.