Provider Demographics
NPI:1780082180
Name:ADACHI, JAYMIE (FNP)
Entity type:Individual
Prefix:MS
First Name:JAYMIE
Middle Name:
Last Name:ADACHI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 DEER MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2223
Mailing Address - Country:US
Mailing Address - Phone:917-796-5792
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:710 ROUTE 28
Practice Address - Street 2:
Practice Address - City:HARWICH PORT
Practice Address - State:MA
Practice Address - Zip Code:02646-1931
Practice Address - Country:US
Practice Address - Phone:508-432-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339291363LF0000X
MA2322504363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04075292Medicaid
NY00695941Medicaid
WI331945Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
NY04075292Medicaid
WI331058Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
NY00695941Medicaid
WI331946Medicare Oscar/Certification
WI331947Medicare Oscar/Certification
WI331043Medicare Oscar/Certification