Individual provider Active NPI

Jared Chase Grochowsky, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1194046748
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243958 Issued in MA
Practice address
330 Brookline Ave
Deaconess 311
Boston, MA 02215-5400
Phone
(617) 754-0100
Fax
(617) 754-0230
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 243958 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Deaconess 311
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Deaconess 311
Boston, MA 02215-5400
Phone (617) 754-0100

Other identifiers 1

IdentifierTypeStateIssuer
243958OtherMALIMITED LICENSE

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
I20130717000757 MA Practitioner - Internal Medicine 3072753946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243958MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Single Specialty CurrentSince Jul 1, 2015 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Single Specialty CurrentSince Jul 1, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Single Specialty CurrentSince Jul 1, 2013 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. Single Specialty CurrentSince Jul 1, 2013 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Single Specialty CurrentSince Jul 1, 2015 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Single Specialty Past Accepting new patients

Locations

330 Brookline Ave
#311
Boston, MA 02215
Phone (617) 754-0100

330 Brookline Ave
#2
Boston, MA 02215
Phone (617) 632-8383

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

Interoperability endpoints

  • Direct secure messaging: jgrochowsky254437@direct.bilh.masshiway.net

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1194046748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "DEACONESS 311",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-754-0100",
            "fax_number": "617-754-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "DEACONESS 311",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-754-0100",
            "fax_number": "617-754-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCHOWSKY",
        "first_name": "JARED",
        "middle_name": "CHASE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "243958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMITED LICENSE",
            "identifier": "243958",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.