Individual provider Active NPI

Jerome Paul Richie, MD

  • Urology Physician
  • Boston, MA
National Provider Identifier
1396797619
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
41061 Issued in MA
Practice address
45 Francis Street Asbii 3
Brigham and Womens Hospital Division of Urology
Boston, MA 02115
Phone
(617) 732-5500
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 41061 MA Primary

Addresses

Primary practice location

45 Francis Street Asbii 3
Brigham and Womens Hospital Division of Urology
Boston, MA 02115

Mailing address

111 Cypress St
Brigham and Womens Hospital Division of Urology
Brookline, MA 02445-6002
Phone (857) 307-0896

Other identifiers 1

IdentifierTypeStateIssuer
2052431MedicaidMA

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
I20050103000180 MA Practitioner - UrologyPractitioner - Other (Physician) 9436117801 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc CurrentSince Nov 16, 2004 Accepting new patients

Organizations & group practices 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1396797619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "address_2": "BRIGHAM AND WOMENS HOSPITAL DIVISION OF UROLOGY",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456002",
            "telephone_number": "857-307-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 FRANCIS STREET ASBII 3",
            "address_2": "BRIGHAM AND WOMENS HOSPITAL DIVISION OF UROLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHIE",
        "first_name": "JEROME",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "41061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052431",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.