Active NPI
Jamelah D Tucker, MD
- Pediatrics Physician
- Boston, MA
National Provider Identifier
1073711768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 249948
- Practice address
- 800 Washington St #286
Floating Hospital for Children at Tufts Medical Center
Boston, MA 02111 - Phone
- (978) 788-7230
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D66354 | MD | |
| Pediatrics Physician | 208000000X | 249948 | MA | Primary |
| Pediatrics Physician | 208000000X | ME 107469 | FL | |
| Pediatrics Physician | 208000000X | 6712 | AK |
Addresses
Primary practice location
800 Washington St #286
Floating Hospital for Children at Tufts Medical Center
Boston, MA 02111
Mailing address
1835 E Hallandale Beach Blvd # 327
Hallandale Beach, FL 33009-4619
Phone (786) 530-7952
Other practice location 1
1117 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4488
Phone (954) 454-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 412724200 | Medicaid | MD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000542 | MA | Practitioner - Pediatric Medicine | 2466533971 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5316 | AK | MD | Family Medicine Physician |
| 6712 | AK | MD | Pediatrics Physician |
| ME 107469 | FL | MD | Pediatrics Physician |
| 249948 | MA | MD | Pediatrics Physician |
| D66354 | MD | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1073711768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 E HALLANDALE BEACH BLVD # 327",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330094619",
"telephone_number": "786-530-7952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST #286",
"address_2": "FLOATING HOSPITAL FOR CHILDREN AT TUFTS MEDICAL CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "978-788-7230"
}
],
"practiceLocations": [
{
"address_1": "1117 E Hallandale Beach Blvd",
"address_purpose": "LOCATION",
"city": "Hallandale Beach",
"state": "FL",
"postal_code": "330094488",
"country_code": "US",
"telephone_number": "954-454-5131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TUCKER",
"first_name": "JAMELAH",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D66354",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "249948",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 107469",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AK",
"license": "6712",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "412724200",
"state": "MD"
}
],
"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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.