Organization Active NPI

American Well Medical Group Ca, PC

  • Multi-Specialty Clinic/Center
  • Boston, MA
National Provider Identifier
1134925241
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
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

Updated by the provider on Feb 20, 2025

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.