Active NPI
American Well Medical Group Ca, PC
- Multi-Specialty Clinic/Center
- Boston, MA
National Provider Identifier
1134925241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- AMERICAN WELL MEDICAL GROUP CA, PC
- Practice address
- 75 State St Ste 26
Boston, MA 02109-1827 - Phone
- (617) 204-3500
- NPI assigned
- Feb 20, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cynthia Horner, MD
- Title
- Owner
- Phone
- (703) 505-6002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
75 State St Ste 26
Boston, MA 02109-1827
Mailing address
75 State St Ste 26
Boston, MA 02109-1827
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740009600000",
"number": "1134925241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 STATE ST STE 26",
"city": "BOSTON",
"state": "MA",
"postal_code": "021091827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 STATE ST STE 26",
"city": "BOSTON",
"state": "MA",
"postal_code": "021091827",
"telephone_number": "617-204-3500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN WELL MEDICAL GROUP CA, PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-20",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A",
"authorized_official_last_name": "HORNER",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-505-6002",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.