Active NPI
Timothy Edwin Wilens, MD
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1295716074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 57251
- Practice address
- 55 Fruit St
Yaw 6900
Boston, MA 02114-2621 - Phone
- (617) 726-1731
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 57251 | MA | |
| Psychiatry Physician | 2084P0800X | 57251 | MA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 57251 | MA |
Addresses
Primary practice location
55 Fruit St
Yaw 6900
Boston, MA 02114-2621
Mailing address
PO Box 9142
Charlestown, MA 02129-9142
Phone (617) 724-5600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 724343 | Other | MA | TUFTS HEALTH PLAN |
| 3046974 | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Michigan Medical School, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Psychiatry | Current | Accepting new patients |
| The General Hospital Corporation | Current | Accepting new patients | |
| General Hospital Corp | Current | Accepting new patients |
Locations
55 Fruit St
#6900
Boston, MA 02114
Phone (617) 724-3163
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
Interoperability endpoints
- wilens.timothy.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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
Psychiatry
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1295716074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9142",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021299142",
"telephone_number": "617-724-5600",
"fax_number": "617-724-3742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"address_2": "YAW 6900",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-1731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILENS",
"first_name": "TIMOTHY",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "MA",
"license": "57251",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "57251",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "57251",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "724343",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3046974",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.