Jessica Jeanne Sullivan, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN2306549 Issued in MA

Practice address

55 Fogg Rd
Weymouth, MA 02190-2432

Phone

(781) 624-8000

NPI assigned

Feb 2, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jessica Jeanne Sullivan Other name

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4

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.

• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment Care Compare group NPD
• Mount Auburn Professional Services Inc

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1992750996
  Medicare reassignment NPD
• Mt Auburn Professional Services

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1013375203
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1982142519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021273214",
            "country_code": "US",
            "telephone_number": "617-997-5904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSICA",
        "middle_name": "JEANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2306549",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2306549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SULLIVAN",
            "middle_name": "JEANNE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Strength Recovery Services LLC
• Jacob Ethan Strous, OD
• Melyssa Sueiro, M.S.
• Alyson Nicole Sullivan, BA
• Elana Sullivan, M.D.
• Joyce M Sullivan, OTR
• Julie Armstrong Sullivan, SLP
• Kathleen Connelly Sullivan, MS, PA-C
• Maria Catherine Sullivan
• Ryan J Sullivan, M.D.

• Gerontology Nurse Practitioner in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.