DR. JACKIE S FANTES (MD) – Family Medicine Physician, NPI 1275530719
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JACKIE S FANTES (MD)
179 Quincy St Ste 2
Brockton, MA 023022966
Phone: (508) 283-3154
Fax: (833) 450-5159
Type: Location
205 Parkingway
Quincy, MA 02169
Phone: (617) 820-5968
Fax: (833) 471-5603
Type: Location
301 Columbia Rd
Boston, MA 021213409
Phone: (617) 237-6838
Fax: (833) 450-5158
Type: Location
East Boston Neighborhood Health Center, 10, Gove Street, East Boston, Boston, Suffolk County, Massachusetts, 02152, United States
EAST BOSTON, MA 021281920
Phone: (617) 569-5800
Fax: (617) 568-4780
Type: Mailing
50 Boston St
Lynn, MA 019042538
Phone: (781) 342-4191
Fax: (833) 450-5157
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2015-04-03
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 |
|---|---|---|---|---|
| I20150403000757 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 25 | 17 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 14 | $0 |
Insurance plans in this area (ZIP 02302)
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