MS. JACQUELYN ELISE PENNIE (PA) – Physician Assistant, NPI 1134536055
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
Provider Addresses for MS. JACQUELYN ELISE PENNIE (PA)
147 MILK STREET
HARVARD VANGUARD MEDICAL ASSOCIATES AT POS.
BOSTON, MA 02109
Phone: (617) 654-7200
Fax: (617) 654-7176
Type: Mailing
675 PARAMOUNT DR
SUITE 203
RAYNHAM, MA 027675416
Phone: (508) 880-0012
Type: Location
1 LYONS STREET
ATRIUS HEALTH, INC
BOSTON, MA 02026
Phone: (617) 657-6495
Type: Mailing
1 LYONS ST
DEDHAM, MA 020265599
Phone: (508) 880-0012
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $140.
Total Amount is formed as General ($140) + Research ($0) + Ownership ($0) = $140.
Last reported payment date: 2023-09-21 • Largest payer in this snapshot: Smith+Nephew, Inc. ($140).
Total Amount
$140
General + Research + Ownership
Payments
1
Total payment records
General Amount
$140
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $140 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-01-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150106000105 | I | Physician Assistant | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 294 | 88 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 146 | 69 | $0 |
| 29580 | Strapping, unna boot | 95 | 34 | $0 |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 57 | 29 | $0 |
| 87205 | Special gram or giemsa stain for microorganism | 56 | 37 | $0 |
Insurance plans in this area (ZIP 02109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| Family Practice | MA | |
| D E R M A T O L O G Y | MA | |
| Emergency Medicine | MA | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MA | |
| - | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| - | MA | |
| Internal Medicine | MA | |
| O T O L A R Y N G O L O G Y | MA |
Reviews
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