Jerry Greene, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

45681 Issued in MA

Practice address

1400 VFW Pkwy
C/O Medical Service 111
West Roxbury, MA 02132

Phone

(617) 323-7700

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1144318916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SAWYER RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533471",
            "telephone_number": "781-392-2008",
            "fax_number": "781-642-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "address_2": "C/O MEDICAL SERVICE 111",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "617-323-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MA",
            "license": "45681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3060019",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Edward Gooey, M.D.
• Carrigan Fate Gould, OD
• Raj Kumar Goyal, M.D.
• Gary D Gramigna, M.S., CCC-SLP
• Mason Bartley Gray, DPT, PT
• David Samuel Greenstein, O.D. , M. S.
• Beverly Fay Greenwold, M.D.
• Ashley B Griffin, MSW
• Anna Anush Grigorian, NURSE
• Sarah Clark Grudberg, MD

• Rheumatology Physician in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Rheumatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.