Individual provider Active NPI

Jesse David Roberts Jr., MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1326038456
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
73198 Issued in MA
Practice address
55 Fruit Street FND 442
Massachusetts General Hospital New Born Service
Boston, MA 02114-2696
Phone
(617) 726-9040
Fax
(617) 726-9346
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 73198 MA
Pediatrics Physician 208000000X 73198 MA Primary

Addresses

Primary practice location

55 Fruit Street FND 442
Massachusetts General Hospital New Born Service
Boston, MA 02114-2696

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-0287

Other identifiers 3

IdentifierTypeStateIssuer
073198OtherMATUFTS HEALTH PLAN
3074196MedicaidMA
J10293OtherMABCBS 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000292 MA Practitioner - AnesthesiologyPractitioner - Pediatric MedicinePractitioner - Other (Physician) 5597702803 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73198MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Feb 14, 2013 Accepting new patients
The Shriners' Hospital for Children Current Accepting new patients
The Shriners' Hospital for Children Anesthesiology CurrentSince Jul 11, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
The Shriners' Hospital for Children CurrentSince Jul 11, 2020 Accepting new patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#442
Boston, MA 02114
Phone (617) 724-2165

516 Carew St
Springfield, MA 01104
Phone (413) 787-2000

Interoperability endpoints

  • Direct secure messaging: roberts.jesse.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326038456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-724-0287",
            "fax_number": "617-726-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET FND 442",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL NEW BORN SERVICE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-9040",
            "fax_number": "617-726-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JESSE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "73198",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "73198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "073198",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074196",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J10293",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.