Individual provider Active NPI

Jacob Matt Elkon, MD

  • Hematology & Oncology Physician
  • Boston, MA
National Provider Identifier
1104153105
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
284382 Issued in MA
Practice address
800 Washington St # 245
Boston, MA 02111-1552
Phone
(617) 636-6227
NPI assigned
Nov 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X 284382 MA Primary

Addresses

Primary practice location

800 Washington St # 245
Boston, MA 02111-1552

Mailing address

96 N Main St
Sharon, MA 02067-1206
Phone (478) 318-5409

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
I20201021002174 MA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7517256597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

  • Tufts Medical Center Hospital, Boston, MA, CCN 220116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284382MAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Multi-Specialty Current Accepting new patients
Pratt Medical Group, Inc Multi-Specialty CurrentSince Sep 1, 2020 Accepting new patients
Pratt Medical Group, Inc Multi-Specialty CurrentSince Sep 1, 2020 Accepting new patients
Tufts Medical Center, Inc. Multi-Specialty Past Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#245
Boston, MA 02111
Phone (617) 636-6227

Interoperability endpoints

  • Direct secure messaging: jelkon29122@tuftsmedicine.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1104153105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 N MAIN ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671206",
            "telephone_number": "478-318-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 245",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKON",
        "first_name": "JACOB",
        "middle_name": "MATT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MA",
            "license": "284382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.