Individual provider Active NPI

Jack Bragg, MD

  • Orthopaedic Surgery Physician
  • Boston, MA
National Provider Identifier
1184329575
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3014391 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Apr 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3014391 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

800 Washington St # 306
Boston, MA 02111-1552
Phone (617) 636-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3014391MAMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: jbragg175432@direct.bilh.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1184329575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 306",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "3014391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.