Individual provider Active NPI

John J Worthington III, MD

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1164490512
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
78113 Issued in MA
Practice address
15 Parkman St
Wac 815
Boston, MA 02114-3117
Phone
(617) 724-0855
Fax
(617) 726-7541
NPI assigned
Mar 10, 2006
Last updated
Dec 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 78113 MA Primary

Addresses

Primary practice location

15 Parkman St
Wac 815
Boston, MA 02114-3117

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-0855

Other identifiers 3

IdentifierTypeStateIssuer
J30210OtherMABCBS MA
737688OtherMATUFTS HEALTH PLAN
3120546MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110001101 MA Practitioner - Psychiatry 2062460611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Georgetown University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Psychiatry CurrentSince Sep 22, 2014 Accepting new patients

Locations

15 Parkman St
#815
Boston, MA 02114
Phone (617) 726-3488

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

Interoperability endpoints

  • Direct secure messaging: worthington.john.mgh@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1164490512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-724-0855",
            "fax_number": "617-643-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "WAC 815",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "617-724-0855",
            "fax_number": "617-726-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "78113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J30210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "737688",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3120546",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.