Individual provider Active NPI

Stephen A Jenkins, M.D

  • Pediatrics Physician
  • Concord, MA
National Provider Identifier
1447238928
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
50863 Issued in MA
Practice address
330 Baker Ave
Concord, MA 01742-2129
Phone
(978) 287-9400
Fax
(978) 287-9408
NPI assigned
Jan 5, 2006
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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 50863 MA Primary

Addresses

Primary practice location

330 Baker Ave
Concord, MA 01742-2129

Mailing address

330 Baker Ave
Concord, MA 01742-2129
Phone (978) 287-9400

Other identifiers 8

IdentifierTypeStateIssuer
1202094OtherMAUNITED HEALTHCARE
B10207702OtherMACIGNA
7793OtherMAHARVARD PILGRIM
J03363OtherMABLUE CROSS
4019954OtherMAAETNA
6186866MedicaidMA
0016159OtherMANEIGHBORHOOD HEALTH
702904OtherMATUFTS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjenkinsmd14438@direct.atrius.masshiway.net

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
I20050323000800 MA Practitioner - Pediatric Medicine 4183670136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50863MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Apr 1, 2011 Accepting new patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

330 Baker Ave
Concord, MA 01742
Phone (978) 287-9300

86 Baker Avenue Ext
Concord, MA 01742
Phone (978) 287-9300

Interoperability endpoints

  • Direct secure messaging: sjenkinsmd14438@direct.atrius.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1447238928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9400",
            "fax_number": "978-287-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9400",
            "fax_number": "978-287-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "50863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1202094",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B10207702",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "7793",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J03363",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4019954",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6186866",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0016159",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "702904",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjenkinsmd14438@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "330 Baker Ave",
            "city": "Concord",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017422129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.