Individual provider Active NPI

Jose Alberto Valles Feliciano, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1104326743
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1023401 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(787) 758-2525
NPI assigned
Feb 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 1023401 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

202 Mill Rd Apt 657
Everett, MA 02149-3174
Phone (787) 225-0858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250616002193 MA Practitioner - Diagnostic Radiology 5890206957 Reassigns benefits to 2 organizations
I20250626003915 NH Practitioner - Diagnostic Radiology 5890206957 Reassigns benefits to 1 organization
I20260506003192 NY Practitioner - Diagnostic Radiology 5890206957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Puerto Rico School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

151 Everett Ave
Chelsea, MA 02150-1812
Phone (617) 884-8300

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

67 Corporate Dr
BLDG a
Portsmouth, NH 03801-2847
Phone (603) 431-5529

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation Single Specialty CurrentSince Jun 10, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Single Specialty CurrentSince Jun 10, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

67 Corporate Dr
Bldg A
Portsmouth, NH 03801
Phone (603) 431-5529

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

Organizations & group practices 3

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 7

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1104326743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MILL RD APT 657",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493174",
            "telephone_number": "787-225-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLES FELICIANO",
        "first_name": "JOSE",
        "middle_name": "ALBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1023401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.