Active NPI
Jane E Clancy, MD
- Diagnostic Radiology Physician
- Somerville, MA
National Provider Identifier
1124088844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 48219
- Practice address
- 40 Holland St
Somerville, MA 02144-2705 - Phone
- (617) 629-6000
- Fax
- (617) 972-5100
- NPI assigned
- Mar 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 48219 | MA | Primary |
Addresses
Primary practice location
40 Holland St
Somerville, MA 02144-2705
Mailing address
147 Milk St
9TH Floor
Boston, MA 02109-4806
Phone (617) 421-2508
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J04214 | Other | MA | BLUE CROSS |
| 3014118 | Medicaid | MA | |
| B21211801 | Other | MA | HEALTHSOURCE |
| R209 | Other | MA | HARVARD PILGRIM |
| 0000849 | Other | MA | NEIGHBORHOOD HEALTH |
| 1971454-001 | Other | MA | CIGNA |
| 702782 | Other | MA | TUFTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375401600000",
"number": "1124088844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-421-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442705",
"telephone_number": "617-629-6000",
"fax_number": "617-972-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "JANE",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-25",
"last_updated": "2013-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "48219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J04214",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3014118",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "B21211801",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "R209",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0000849",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1971454-001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "702782",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.