Active NPI
Jessica R Poulin, M.D.
- Maternal & Fetal Medicine Physician
- Palm Beach Gardens, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- ME119737
- 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, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015052200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, AL, WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN15983 | FL | MD | Obstetrics & Gynecology Physician |
| ME119737 | FL | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Care Authority for Baptist Health, an Affiliate of Uabhs | Current | Accepting new patients | |
| North Lincoln County Hospital District | Current | Accepting new patients | |
| Critical Perinatal Solutions P.C. | Maternal & Fetal Medicine | Current | Accepting new patients |
| Health Care Authority for Baptist Health, an Affiliate of Uabhs | Current | Accepting new patients | |
| North Lincoln County Hospital District | Current | Accepting new patients | |
| FWC Perinatal, LLC | Maternal & Fetal Medicine | Current | 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
- 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.
-
- Maternal & Fetal Medicine Physician
- Tampa, FL
- NPI 1831485093
-
dba Montgomery Primary Medicine Associates
- Family Medicine Physician
- Montgomery, AL
- NPI 1982653390
-
dba Star Valley Medical Center
- Critical Access Hospital
- Afton, WY
- NPI 1255376406
-
dba Star Valley Medical Center
- Family Medicine Physician
- Afton, WY
- NPI 1730132523
-
dba Baptist Health Care Partners
- Internal Medicine Physician
- Montgomery, AL
- NPI 1033534524
-
dba Montgomery Cardiovascular Associates
- Cardiovascular Disease Physician
- Montgomery, AL
- NPI 1427822279
-
dba Baptist Medical Center South - Wound Care
- Clinic/Center
- Montgomery, AL
- NPI 1538347067
-
dba Alabama Oncology Hematology Associates
- Hematology & Oncology Physician
- Montgomery, AL
- NPI 1972749398
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.