Provider Demographics
NPI:1568467355
Name:SCHOONMAKER, JESSICA (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SCHOONMAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:260 MERRIMAC ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2192
Mailing Address - Country:US
Mailing Address - Phone:978-499-7200
Mailing Address - Fax:978-499-7463
Practice Address - Street 1:260 MERRIMAC ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2192
Practice Address - Country:US
Practice Address - Phone:978-499-7200
Practice Address - Fax:978-499-7463
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA219381207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2034301Medicaid
971937OtherNEWTWORK HEALTH
MA1568467355OtherAETNA HMO
MAJ26850OtherBLUE CROSS BLUE SHIELD
MA7949473OtherAETNA NON HMO
8613817OtherCIGNA HEALTHCARE
MA0031197OtherNEIGHBORHOOD HEALTH PLAN
NH30203905OtherNH MEDICAID
NHH88477OtherANTHEM BLUE CROSS
MA1568467355OtherFALLON COMMUNITY HEALTH PLAN
MA6000673OtherHARVARD PILGRIM HEALTHCAR
04-41304OtherEVERCARE
MA467519OtherTUFTS HEALTH PLAN
MA1568467355OtherFALLON COMMUNITY HEALTH PLAN
MA6000673OtherHARVARD PILGRIM HEALTHCAR