Individual provider Active NPI

Jeffrey Mark Drazen, M.D.

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1003892803
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
36140 Issued in MA
Practice address
725 Albany St
Shapiro 9, Suite B
Boston, MA 02118-2526
Phone
(617) 638-7480
Fax
(617) 638-7486
NPI assigned
Dec 22, 2005
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 36140 MA Primary

Addresses

Primary practice location

725 Albany St
Shapiro 9, Suite B
Boston, MA 02118-2526

Mailing address

850 Harrison Ave
Yacc BN-C7
Boston, MA 02118-4001
Phone (617) 414-5405

Other identifiers 1

IdentifierTypeStateIssuer
2054787MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050927001068 MA Practitioner - Pulmonary Disease 2769417914 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Hospital Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

75 Francis St
#H
Boston, MA 02115
Phone (617) 732-4918

Interoperability endpoints

  • Direct secure messaging: drazen.jeffrey.bwh@direct.partners.masshiway.net

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nantucket Cottage HospitalNantucket, MA, CCN 220177 Hospital Corporate Director Aug 16, 2019
Nantucket Cottage HospitalNantucket, MA, CCN 22U177 Hospital Corporate Director Aug 16, 2019
Nantucket Cottage Medical GroupNantucket, MA, CCN 223979 Rural health clinic Corporate Director Aug 16, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1003892803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC BN-C7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-5405",
            "fax_number": "617-414-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 9, SUITE B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-7480",
            "fax_number": "617-638-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAZEN",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "36140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2054787",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.