NPIMap

Individual provider Active NPI

Aimee C. Kobjack, MD

  • Family Medicine Physician
  • Harvard, MA
National Provider Identifier
1104358001
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
282879 Issued in MA
Practice address
198 Ayer Rd
Harvard, MA 01451-1163
Phone
(978) 456-2355
Fax
(978) 456-2356
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 282879 MA Primary

Addresses

Primary practice location

198 Ayer Rd
Harvard, MA 01451-1163

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address akobjack28742@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200914000574 MA Practitioner - Family Practice 2365715349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

198 Ayer Rd
Harvard, MA 01451-1163
Phone (978) 456-2355

Hospital & facility affiliations

  • Caretenders Home health agency, Needham Heights, MA, CCN 227269
  • Health Alliance Home Health and Hospice Home health agency, Leominster, MA, CCN 227009
  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282879MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Aug 31, 2020 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 31, 2020 Accepting new patients

Locations

198 Ayer Rd
Harvard, MA 01451
Phone (978) 456-2355

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

279 Lincoln St
Worcester, MA 01605
Phone (508) 334-2537

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: akobjack28742@umassmemorial.direct-ci.com

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.

Hospital & facility affiliations 8

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1104358001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 AYER RD",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "014511163",
            "telephone_number": "978-456-2355",
            "fax_number": "978-456-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBJACK",
        "first_name": "AIMEE",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "282879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akobjack28742@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "198 Ayer Rd",
            "city": "Harvard",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014511163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "198 Ayer Rd",
            "city": "Harvard",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014511163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harvard, MA

Sources for this page

Verify at the official NPI Registry.