Dr Jacqueline R Sly, FNP, DNP is a medicare enrolled "Internal Medicine - Interventional Cardiology" in Brockton, Massachusetts. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice St Marys Regional Medical Center, Mainehealth and her current practice location is
110 Liberty St, Brockton, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(508) 894-0400.
Dr Jacqueline R Sly is licensed to practice in Maine (license number CNP221579) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912284316.
Provider's Profile
| Full Name | Dr Jacqueline R Sly |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 110 Liberty St, Brockton, Massachusetts |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jacqueline R Sly graduated from nursing school in 2020
NPI Data:
- NPI Number: 1912284316
- Provider Enumeration Date: 11/14/2011
- Last Update Date: 08/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749449569
- Enrollment ID: I20230215000159
Medical Identifiers
Medical identifiers for Dr Jacqueline R Sly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912284316 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | CNP221579 (Maine) | Secondary |
| 364SF0001X | Clinical Nurse Specialist - Family Health | RN189769 (Massachusetts) | Secondary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | CNP221579 (Maine) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| St Marys Regional Medical Center | 0042107120 | 186 |
| Mainehealth | 7517860588 | 2109 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jacqueline R Sly allows following entities to bill medicare on her behalf.
| Entity Name | St Marys Regional Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447226584
PECOS PAC ID: 0042107120
Enrollment ID: O20040303000236 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jacqueline R Sly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jacqueline R Sly, FNP, DNP
8 Pikes Hl,
Norway, ME 04268-5340
Ph: (207) 744-6444 | Dr Jacqueline R Sly, FNP, DNP
110 Liberty St,
Brockton, MA 02301
Ph: (508) 894-0400 |
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