Individual provider Active NPI

Jasmine Mikami, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1417482126
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
288398 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-2000
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 288398 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

33 Smith Garrison Rd
Newmarket, NH 03857-1714

Other practice location 1

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211202000574 MA Practitioner - Pediatric Medicine 3072935659 Reassigns benefits to 3 organizations
I20231018003367 NH Practitioner - Pediatric Medicine 3072935659 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288398MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Nov 1, 2023 Accepting new patients
Core Physicians, LLC Pediatrics CurrentSince Jan 15, 2024 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Nov 1, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Core Physicians LLC CurrentSince Jan 15, 2024 Accepting new patients
The General Hospital Corporation CurrentSince Nov 1, 2023 Accepting new patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Oct 1, 2021 Accepting new patients
Wentworth Douglass Hospital Past Accepting new patients

Locations

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

55 Fruit St
Boston, MA 02114

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

789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

5 Alumni Dr
Fl 2
Exeter, NH 03833
Phone (603) 580-7525

3 Alumni Dr
Ste 301
Exeter, NH 03833
Phone (603) 658-1180

7 Holland Way
#1
Exeter, NH 03833

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

Interoperability endpoints

  • Direct secure messaging: jmikami519843@direct.bilh.masshiway.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mikami.jasmine.wdh@direct.partners.masshiway.net

Organizations & group practices 9

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1417482126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SMITH GARRISON RD",
            "city": "NEWMARKET",
            "state": "NH",
            "postal_code": "038571714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038202526",
            "country_code": "US",
            "telephone_number": "603-740-2263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKAMI",
        "first_name": "JASMINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "288398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.