Active NPI
Mavis Webster Jaworski, MD
- Family Medicine Physician
- Beverly, MA
National Provider Identifier
1154483931
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 19, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 151523
- Practice address
- 25 Hale St
Floor 1
Beverly, MA 01915-5268 - Phone
- (978) 921-5885
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 151523 | MA | Primary |
Addresses
Primary practice location
25 Hale St
Floor 1
Beverly, MA 01915-5268
Mailing address
PO Box 511
Beverly, MA 01915-0411
Phone (978) 225-0022
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine Associates P. C. | Current | Accepting new patients | |
| Tidewater Physicians Multispecialty Group PC | Past | Accepting new patients | |
| Beth Israel Lahey Health Specialty Care, Inc. | Past | Accepting new patients |
Locations
38 Enon St
Beverly, MA 01915
Phone (978) 927-7727
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BGFHDD
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.
-
- Primary Care Clinic/Center
- Beverly, MA
- NPI 1508864828
-
- Internal Medicine Physician
- Gloucester, MA
- NPI 1235147760
-
- Ambulatory Surgical Clinic/Center
- Williamsburg, VA
- NPI 1316790512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396569600000",
"number": "1154483931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 511",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019150411",
"telephone_number": "978-225-0022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HALE ST",
"address_2": "FLOOR 1",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019155268",
"telephone_number": "978-921-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAWORSKI",
"first_name": "MAVIS",
"middle_name": "WEBSTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2014-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "151523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.