Healthcare Provider Details

I. General information

NPI: 1255853917
Provider Name (Legal Business Name): JESSICA AMY CASPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

BETH ISRAEL DEACONESS MEDICAL CENTER, NEUROSURGERY DEPT 110 FRANCIS ST., LMOB SUITE 3B
BOSTON MA
02215
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 617-632-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA6078
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA6078
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: