Individual provider Active NPI

John R. Raftery, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1053529040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
79696 Issued in MA
Practice address
59 Temple PL
Suite 1106
Boston, MA 02111-1307
Phone
(617) 338-5188
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 79696 MA Primary

Addresses

Primary practice location

59 Temple PL
Suite 1106
Boston, MA 02111-1307

Mailing address

62 Prospect St
Reading, MA 01867-2823
Phone (781) 944-9059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79696MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Wellesley Pediatrics Current Accepting new patients

Locations

266 Main St
Ste 18
Medfield, MA 02052

134 South Ave
Weston, MA 02493
Phone (781) 472-2222

Interoperability endpoints

  • Direct secure messaging: raftery.john.paofw@direct.partners.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053529040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 PROSPECT ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018672823",
            "telephone_number": "781-944-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 TEMPLE PL",
            "address_2": "SUITE 1106",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111307",
            "telephone_number": "617-338-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFTERY",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "79696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.