NPIMap

Individual provider Active NPI

Jenny Laheri Mamtora, D.O.

  • Family Medicine Physician
  • Danvers, MA
National Provider Identifier
1457974396
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1017039 Issued in MA
Practice address
480 Maple St
Danvers, MA 01923-4065
Phone
(978) 304-8380
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 1017039 MA Primary

Addresses

Primary practice location

480 Maple St
Danvers, MA 01923-4065

Mailing address

Bilh Merrimack Valley Family Medicine
100 Andover Bypass Street
North Andover, MA 01845
Phone (978) 470-1616

Other practice location 1

Family Medicine Center
40 Medical Park Suite 401
Wheeling, WV 26003
Phone (304) 243-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231023000995 MA Practitioner - Family Practice 8628424090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians

Practice addresses (Care Compare)

1350 Market St
Lynnfield, MA 01940-4048
Phone (781) 213-4050

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

  • Tufts Medicine Care at Home Home health agency, Lowell, MA, CCN 227206
  • Elara Caring Home health agency, Newburyport, MA, CCN 227503
  • Pathways Healthcare Home health agency, Westwood, MA, CCN 227569
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1017039MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Physician Associates, Inc Family Medicine CurrentSince Oct 2, 2023 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Feb 11, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Feb 11, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. PastSince Oct 2, 2023 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

100 Andover Byp
Ste 100
North Andover, MA 01845
Phone (978) 470-1616

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: jmamtora229546@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1457974396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BILH MERRIMACK VALLEY FAMILY MEDICINE",
            "address_2": "100 ANDOVER BYPASS STREET",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-470-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAPLE ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234065",
            "telephone_number": "978-304-8380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Family Medicine Center",
            "address_2": "40 Medical Park Suite 401",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "26003",
            "country_code": "US",
            "telephone_number": "304-243-3880",
            "fax_number": "304-243-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMTORA",
        "first_name": "JENNY",
        "middle_name": "LAHERI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "1017039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.