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DR. JESSICA KELLY CREEDON M.D.
NPI 1306145172
Pediatrics - Pediatric Emergency Medicine in Boston, MA

Active since March 19, 2011PECOS Enrolled
300 LONGWOOD AVE, BOSTON, MA 02115(617) 355-6000 Get Directions Write a Review

NPPES record last updated: December 31, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jessica Kelly Creedon M.d. NPPES

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

DR. JESSICA KELLY CREEDON M.D. (NPI 1306145172) is an individual pediatric emergency medicine provider in Boston, Massachusetts, licensed in Massachusetts (257923) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306145172
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameDR. JESSICA KELLY CREEDONCredential: M.D.
Location Address300 LONGWOOD AVEBoston, MA 02115-5724
Mailing Address300 Longwood AveBoston, MA 02115-5724 · (617) 355-6000
Phone(617) 355-6000
Sole ProprietorNo
Enumeration DateMarch 19, 2011
Last NPPES UpdateDecember 31, 2019
✔ NPI 1306145172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in MA · 257923
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License 257923 (MA)
300 LONGWOOD AVE, Boston, MA 02115
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jessica Kelly Creedon M.d. 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.

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.

JULIE ANN HANSEN LCSW
Social Worker (Clinical)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (857) 218-4309
MS. ANNA ROGLIERI
Nurse Practitioner (Psychiatric/Mental Health)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
STEPHEN G. FLYNN M.D.
Anesthesiology (Pediatric Anesthesiology)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
MISS LAUREN ASHLEY MASTERSON P.T., D.P.T
Physical Therapist
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-7216
MS. SOYUN KWAN LICSW
Social Worker (Clinical)
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON
BOSTON, MA 02115
Suffolk County (617) 355-0567
PUJA BANKA M.D.
Pediatrics
300 LONGWOOD AVE, BADER 203
BOSTON, MA 02115
Suffolk County (617) 355-6363
MR. COURTNEY SULLIVAN FRATTO CPNP
Nurse Practitioner (Pediatrics)
300 LONGWOOD AVE, HUNNEWELL BUILDING 322
BOSTON, MA 02115
Suffolk County (857) 218-4085
DR. ELIZABETH S TAGLAUER M.D., PH.D.
Pediatrics (Neonatal-Perinatal Medicine)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000

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 Creedon's NPI number?

The NPI number for Jessica Creedon is 1306145172. It was assigned to this individual provider in the NPPES registry on March 19, 2011.

Where is Jessica Creedon located?

Jessica Creedon practices at 300 Longwood Ave, Boston, MA 02115. The listed phone number is (617) 355-6000.

What is Jessica Creedon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Jessica Creedon enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jessica Creedon was last updated on December 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.