Individual provider Active NPI

Jedediah Joel Holland, FNP-BC

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1982976775
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2011012631 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-2000
NPI assigned
Feb 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NPP37676 RI
Nurse Practitioner 363L00000X 2011012631 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Other practice location 1

1400 Computer Dr Ste 301
Westborough, MA 01581-1790
Phone (617) 420-5316

Other practice location 2

33 Anthony St
Berkley, MA 02779-1601
Phone (508) 789-3850

Other practice location 3

10 Dorrance St Ste 700
Providence, RI 02903-2014
Phone (833) 229-0957

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
I20140904000171 MA Practitioner - Nurse Practitioner 1052575503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2011012631MAMDNurse Practitioner
NPP37676RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 29, 2024 Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Apr 29, 2024 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

Interoperability endpoints

  • Direct secure messaging: holland.jedediah.mgh@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.

Hospital & facility affiliations 5

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1982976775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Computer Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Westborough",
            "state": "MA",
            "postal_code": "015811790",
            "country_code": "US",
            "telephone_number": "617-420-5316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 Anthony St",
            "address_purpose": "LOCATION",
            "city": "Berkley",
            "state": "MA",
            "postal_code": "027791601",
            "country_code": "US",
            "telephone_number": "508-789-3850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Dorrance St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029032014",
            "country_code": "US",
            "telephone_number": "833-229-0957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JEDEDIAH",
        "middle_name": "JOEL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NPP37676",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2011012631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.