Individual provider Active NPI

Justin M. Rucci, MD

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1104238757
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
276987 Issued in MA
Practice address
1400 VFW Pkwy
Boston, MA 02132-4927
Phone
(857) 203-6478
NPI assigned
May 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 276987 MA
Pediatrics Physician 208000000X 276987 MA
Pulmonary Disease Physician 207RP1001X 276987 MA Primary
Internal Medicine Physician 207R00000X 276987 MA

Addresses

Primary practice location

1400 VFW Pkwy
Boston, MA 02132-4927

Mailing address

150 S Huntington Ave
Jamaica Plain, MA 02130-4817
Phone (617) 232-9500

Other practice location 1

725 Albany St, Suite 9B
Shapiro Bldg
Boston, MA 02118-3549
Phone (617) 638-7480

Other identifiers 2

IdentifierTypeStateIssuer
110136684AMedicaidMA
3138647MedicaidNH

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
I20220603000980 MA Practitioner - Pulmonary Disease 2163772583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276987MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

725 Albany St
Ste 9B
Boston, MA 02118
Phone (617) 414-4290

150 S Huntington Ave
Jamaica Plain, MA 02130
Phone (800) 865-3384

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: jrucci108983@direct.bmc.masshiway.net

Organizations & group practices 2

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1104238757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-6478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St, Suite 9B",
            "address_2": "Shapiro Bldg",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021183549",
            "country_code": "US",
            "telephone_number": "617-638-7480",
            "fax_number": "617-638-7486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCCI",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MA",
            "license": "276987",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "276987",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "276987",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "276987",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110136684A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3138647",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.