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DR. JACKIE S FANTES MD
NPI 1275530719
Family Medicine in East Boston, MA

Active since June 30, 2005PECOS Enrolled
10 GOVE ST, EAST BOSTON, MA 02128(617) 569-5800(617) 568-4780 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jackie S Fantes Md NPPES

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

DR. JACKIE S FANTES MD (NPI 1275530719) is an individual family medicine provider in East Boston, Massachusetts, licensed in Massachusetts (261649) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1275530719
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JACKIE S FANTESCredential: MD
Location Address10 GOVE STEast Boston, MA 02128-1920
Mailing Address10 Gove StEast Boston, MA 02128-1920 · (617) 569-5800 · Fax (617) 568-4780
Phone(617) 569-5800
Fax(617) 568-4780
Sole ProprietorNo
Enumeration DateJune 30, 2005
Last NPPES UpdateMay 8, 2024
NPPES CertifiedApril 29, 2024
✔ NPI 1275530719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MA · 261649
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
10 GOVE ST, East Boston, MA 02128
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Secondary Practice Locations 4

Location 1179 Quincy St Ste 2Brockton, MA 02302-2966 · Phone (508) 283-3154 · Fax (833) 450-5159
Location 2205 ParkingwayQuincy, MA 02169 · Phone (617) 820-5968 · Fax (833) 471-5603
Location 3301 Columbia RdBoston, MA 02121-3409 · Phone (617) 237-6838 · Fax (833) 450-5158
Location 450 Boston StLynn, MA 01904-2538 · Phone (781) 342-4191 · Fax (833) 450-5157

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jackie S Fantes Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Jackie Fantes reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Neighborhealth Corporation
Same address
Community Health
10 GOVE ST
East Boston, MA 02128
  • Reassigned Medicare billing, Massachusetts enrollment
  • Medicare enrollment name: East Boston Neighborhood Health Center Corp
  • 456 clinicians in this Medicare group
NPI 1316994411 (617) 569-5800
Internal Medical Associates-Ebnhc
Same address
Community Health
10 GOVE ST
East Boston, MA 02128
  • Reassigned Medicare billing, Massachusetts enrollment
  • 577 clinicians in this Medicare group
NPI 1558481879 (617) 569-5800
Gather Health Primary Care Of Massachusetts PC
9.0 mi
Family Medicine
205 PARKINGWAY
Quincy, MA 02169
  • Reassigned Medicare billing, Massachusetts enrollment
  • 24 clinicians in this Medicare group
NPI 1255051850 (617) 820-5968

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
35 services35 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
18 services18 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
17 services17 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
15 services15 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. SUTAPA GHOSH M.D.
Obstetrics & Gynecology
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
ANU RUPA MEHRA MD
Family Medicine
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
SHEREEN MOHIUDDIN M.D.
Family Medicine (Geriatric Medicine)
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
DOMINIQUE CARUSO MURPHY PA-C
Physician Assistant (Medical)
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
MS. CAITLIN R CROWLEY FNP-BC
Nurse Practitioner (Family)
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
KARIN LESCHLY M.D.
Family Medicine
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
LILIANA MANTILLA LMHC
Counselor (Mental Health)
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
ARILENE I. HERNANDEZ LCSW
Social Worker (Clinical)
10 GOVE ST
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800

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 Jackie Fantes's NPI number?

The NPI number for Jackie Fantes is 1275530719. It was assigned to this individual provider in the NPPES registry on June 30, 2005.

Where is Jackie Fantes located?

Jackie Fantes practices at 10 Gove St, East Boston, MA 02128. The listed phone number is (617) 569-5800.

What is Jackie Fantes's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jackie Fantes enrolled in Medicare?

Yes. Jackie Fantes is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jackie Fantes's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jackie Fantes reassigns Medicare benefits to 3 organizations: Neighborhealth Corporation (East Boston, MA), Internal Medical Associates-Ebnhc (East Boston, MA) and Gather Health Primary Care Of Massachusetts PC (Quincy, MA). Each 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 Jackie Fantes's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jackie Fantes was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.