Jason Lanier Outlaw, DMD, DMSC

Primary specialty

DentistTaxonomy code 122300000X

License

DN1858198 Issued in MA

Practice address

1575 Blue Hill Ave
Boston, MA 02126-2122

Phone

(617) 296-0061

NPI assigned

Jun 26, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joutlaw760371@direct.ochin.org

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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  Medicare reassignment NPD
• Upham'S Corner Health Committee, Inc.

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1780780486
  Medicare reassignment NPD
• Mattapan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Mattapan, MA
  • NPI 1639240393
  NPD (past)

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1184144651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 DORCHESTER AVE",
            "address_2": "#51237",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02205",
            "telephone_number": "312-731-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BLUE HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021262122",
            "telephone_number": "617-296-0061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Washington St",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021243510",
            "country_code": "US",
            "telephone_number": "617-822-8142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Bethany Rd",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017027237",
            "country_code": "US",
            "telephone_number": "508-872-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "JASON",
        "middle_name": "LANIER",
        "name_prefix": "Dr.",
        "credential": "DMD, DMSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.