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JESSICA FAVAZZA ROBERGE RD
NPI 1114510807
Dietitian, Registered in Portsmouth, NH

Active since February 15, 2021
67 CORPORATE DR STE 300, PORTSMOUTH, NH 03801(603) 610-8079(603) 868-8375 Get Directions Write a Review

NPPES record last updated: December 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 13, 2022, Feb 15, 2021 (2 updates tracked since 2021).

About Jessica Favazza Roberge Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA FAVAZZA ROBERGE RD (NPI 1114510807) is an individual dietitian, registered in Portsmouth, New Hampshire, licensed in New Hampshire (1052) and active in the NPI registry since February 2021. She maintains a secondary practice location in Laconia.

NPPES Registry Identity

NPI1114510807
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameJESSICA FAVAZZA ROBERGECredential: RD
Location Address67 CORPORATE DR STE 300Portsmouth, NH 03801-2847
Mailing AddressPo Box 412503Boston, MA 02241-2503 · (603) 610-8079
Phone(603) 610-8079
Fax(603) 868-8375
Sole ProprietorYes
Enumeration DateFebruary 15, 2021
Last NPPES UpdateDecember 13, 20222 updates tracked since enumeration
NPPES CertifiedDecember 13, 2022
✔ NPI 1114510807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in NH · 1052
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Also ListedDietitian, Registered · Nutrition, Obesity and Weight ManagementTaxonomy 133VN1201X · License 1052 (NH)
67 CORPORATE DR STE 300, Portsmouth, NH 03801
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Other Names 1

Former Name (1)Jessica Grace Favazza Rd

Secondary Practice Location 1

Location 1276 Mechanic StLaconia, NH 03246-2539 · Phone (603) 770-6564

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include WellSense Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Favazza Roberge Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jessica Roberge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wentworth Douglass Physician Corporation
9.5 mi
Magnetic Resonance Imaging
789 CENTRAL AVE
Dover, NH 03820
  • Reassigned Medicare billing, New Hampshire enrollment
  • 559 clinicians in this Medicare group
NPI 1447352430 (603) 742-5252

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WENTWORTH DOUGLASS HOSPITAL
General Acute Care Hospital
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 742-2163
SAMANTHA METEVIER APRN
Nurse Practitioner (Women's Health)
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (036) 108-0796
KARA VALINSKI LICSW
Social Worker (Clinical)
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 610-8079
CHRISTINE KAY APRN, CNM
Advanced Practice Midwife
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 610-8079
MS. SARAH MARIE KERMELEWICZ CNM
Advanced Practice Midwife
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 610-8079
SAGE ANN MIKAMI MD
Obstetrics & Gynecology
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 610-8079
RYAN LENA MD
Obstetrics & Gynecology
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 610-8079
JILLIAN ANN DOYLE LGC
Genetic Counselor, MS
67 CORPORATE DR STE 300
PORTSMOUTH, NH 03801
Rockingham County (603) 516-0092

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Roberge's NPI number?

The NPI number for Jessica Roberge is 1114510807. It was assigned to this individual provider in the NPPES registry on February 15, 2021. The provider is also known as Jessica Grace Favazza Rd.

Where is Jessica Roberge located?

Jessica Roberge practices at 67 Corporate Dr Ste 300, Portsmouth, NH 03801. The listed phone number is (603) 610-8079.

What is Jessica Roberge's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Jessica Roberge enrolled in Medicare?

Yes. Jessica Roberge is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Roberge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Roberge reassigns Medicare benefits to Wentworth Douglass Physician Corporation (Dover, NH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jessica Roberge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Roberge accept?

Health plans from WellSense Health Plan list Jessica Roberge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jessica Roberge was last updated on December 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.