Individual provider Active NPI

J Benjamin Crocker, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1063402790
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
159921 Issued in MA
Practice address
101 Merrimac St Ste 1000
Ambulatory Practice of the Future
Boston, MA 02114-4773
Phone
(617) 724-1100
Fax
(617) 643-8898
NPI assigned
Oct 25, 2005
Last updated
Feb 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 159921 MA Primary

Addresses

Primary practice location

101 Merrimac St Ste 1000
Ambulatory Practice of the Future
Boston, MA 02114-4773

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-1100

Other identifiers 3

IdentifierTypeStateIssuer
0114863MedicaidMA
159921OtherMATUFTS HEALTH PLAN
J23402OtherMABCBS MA

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
I20040723000250 MA Practitioner - Internal Medicine 8921088584 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Personalmds, LLCGroup PAC ID 9234228073, 10 clinicians

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

25 Boylston St
Chestnut Hill, MA 02467-1710
Phone (617) 307-3200

425 Washington St
Woburn, MA 01801-2157
Phone (781) 285-7955

71 Needham St
Newton, MA 02461-1663
Phone (857) 598-4460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159921MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 23, 1999 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Jan 28, 2026 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Jun 22, 2024 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Jun 22, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Aug 23, 1999 Accepting new patients
Mass General Brigham Urgent Care LLC Current Accepting new patients
Personalmds, LLC Internal Medicine Past Accepting new patients

Locations

101 Merrimac St
Ste 1000
Boston, MA 02114
Phone (617) 724-1100

55 Fruit St
Boston, MA 02114

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

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

71 Needham St
Newton, MA 02461
Phone (617) 712-2770

Interoperability endpoints

  • Direct secure messaging: crocker.joseph.puc@direct.partners.masshiway.net

Organizations & group practices 7

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 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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1063402790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-724-1100",
            "fax_number": "617-643-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MERRIMAC ST STE 1000",
            "address_2": "AMBULATORY PRACTICE OF THE FUTURE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144773",
            "telephone_number": "617-724-1100",
            "fax_number": "617-643-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "J",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "159921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114863",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "159921",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J23402",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.