Individual provider Active NPI

Ivana Jarolimova, MD

  • Internal Medicine Physician
  • Brighton, MA
National Provider Identifier
1306833942
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151162 Issued in MA
Practice address
77 Warren St
Brighton, MA 02135-3601
Phone
(617) 562-5260
Fax
(617) 562-5277
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151162 MA Primary

Addresses

Primary practice location

77 Warren St
Brighton, MA 02135-3601

Mailing address

77 Warren St
Brighton, MA 02135-3601
Phone (617) 562-5260

Other identifiers 1

IdentifierTypeStateIssuer
3162117MedicaidMA

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
I20090113000460 MA Practitioner - Internal Medicine 5294898581 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward St. Elizabeth's Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients
Steward St. Elizabeth's Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients

Locations

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

77 Warren St
Fl 1
Brighton, MA 02135
Phone (617) 562-5200

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1306833942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5260",
            "fax_number": "617-562-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5260",
            "fax_number": "617-562-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAROLIMOVA",
        "first_name": "IVANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3162117",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.