Individual provider Active NPI

Jean Suzin Whitten, MD

  • Family Medicine Physician
  • Dorchester, MA
National Provider Identifier
1265477145
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249409 Issued in MA
Practice address
398 Neponset Avenue
Dorchester, MA 02122
Phone
(617) 282-3200
Fax
(617) 282-8201
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101229728 VA
Family Medicine Physician 207Q00000X 249409 MA Primary

Addresses

Primary practice location

398 Neponset Avenue
Dorchester, MA 02122

Mailing address

1135 Morton St
Mattapan, MA 02126-2834
Phone (617) 533-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20171010000266 TX Practitioner - Family Practice 3476729864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

3301 Stalcup Rd
Fort Worth, TX 76119-1726
Phone (817) 702-7150

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249409MAMDFamily Medicine Physician
0101229728VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Nov 6, 2017 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

3301 Stalcup Rd
Ft Worth, TX 76119
Phone (817) 702-7209

Interoperability endpoints

  • Direct secure messaging: jwhitten63144@direct.jpshealth.org

Organizations & group practices 1

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1265477145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-282-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 NEPONSET AVENUE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02122",
            "telephone_number": "617-282-3200",
            "fax_number": "617-282-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTEN",
        "first_name": "JEAN",
        "middle_name": "SUZIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101229728",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "249409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.