Individual provider Active NPI

Maryam Vejdani Jahromi

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1003346396
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
272052 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-8320
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 272052 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

820 Harrison Ave BLDG 3
Boston, MA 02118-2905

Other practice location 1

115 Lincoln St
Framingham, MA 01702-6358
Phone (508) 872-4794

Other practice location 2

820 Harrison Ave Bldg 3
Boston, MA 02118-2905
Phone (617) 638-6610

Other practice location 3

820 Harrison Ave Bldg 3
Boston, MA 02118-2905
Phone (617) 638-6610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230714000325 MA Practitioner - Diagnostic Radiology 3072840230 Reassigns benefits to 3 organizations
I20250218003808 NH Practitioner - Diagnostic Radiology 3072840230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pratt Radiology Associates IncGroup PAC ID 8820989411, 53 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

  • Tufts Medical Center Hospital, Boston, MA, CCN 220116
  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Radiology Associates, Inc Diagnostic Radiology CurrentSince Sep 1, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1003346396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 HARRISON AVE BLDG 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026358",
            "country_code": "US",
            "telephone_number": "508-872-4794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Harrison Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-6610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Harrison Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-6610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEJDANI JAHROMI",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "272052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.