Individual provider Active NPI

Jennifer L Ruiz, M.D.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1104863372
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
227931 Issued in MA
Practice address
1340 Boylston St
Boston, MA 02215-4302
Phone
(617) 267-0900
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 227931 MA Primary

Addresses

Primary practice location

1340 Boylston St
Boston, MA 02215-4302

Mailing address

310 South St
Jamaica Plain, MA 02130-3510
Phone (617) 245-8900

Other names 1

  • Dr. Jennifer L McLain Former name

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
I20240730001795 MA Practitioner - Addiction Medicine 5799880159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Pennsylvania State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fenway Community Health Center, IncGroup PAC ID 0941299655, 79 clinicians

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
227931MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fenway Community Health Center, Inc CurrentSince May 23, 2024 Accepting new patients
Fenway Community Health Center, Inc CurrentSince May 23, 2024 Accepting new patients
Fenway Community Health Center, Inc PastSince May 1, 2022 Accepting new patients

Locations

1340 Boylston St
Boston, MA 02215
Phone (617) 267-0900

7 Haviland St
Boston, MA 02115
Phone (617) 267-0900

142 Berkeley St
Boston, MA 02116
Phone (617) 247-7555

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1104863372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SOUTH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303510",
            "telephone_number": "617-245-8900",
            "fax_number": "617-245-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-267-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "227931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCLAIN",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.