Individual provider Active NPI

Thomas E Jaquith-Houston, M.D.

  • Family Medicine Physician
  • Auburn, MA
National Provider Identifier
1013074681
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
235434 Issued in MA
Practice address
4 Brotherton Way
Auburn, MA 01501-2684
Phone
(508) 721-1199
Fax
(508) 453-8019
NPI assigned
Jan 3, 2007
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 235434 MA Primary

Addresses

Primary practice location

4 Brotherton Way
Auburn, MA 01501-2684

Mailing address

4 Brotherton Way
Auburn, MA 01501-2684
Phone (508) 721-1199

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
I20080818000037 MA Practitioner - Family Practice 9739254350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

4 Brotherton Way
Auburn, MA 01501-2684
Phone (508) 832-9621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235434MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. Family Medicine CurrentSince Jul 21, 2008 Accepting new patients
Reliant Medical Group, Inc Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
Beacon Hospice, LLC Family Medicine Past Accepting new patients

Locations

4 Brotherton Way
Auburn, MA 01501
Phone (508) 425-5446

813 Southbridge St
Auburn, MA 01501
Phone (508) 784-1278

826 Southbridge St
Auburn, MA 01501
Phone (508) 832-0173

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: thomas.jaquithhouston.npi1013074681.reliant@direct.optumcare.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1013074681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BROTHERTON WAY",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012684",
            "telephone_number": "508-721-1199",
            "fax_number": "508-453-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BROTHERTON WAY",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012684",
            "telephone_number": "508-721-1199",
            "fax_number": "508-453-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUITH-HOUSTON",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "235434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.