Individual provider Active NPI

Jorge M Medina, M.D.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1477520930
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
205001 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3850
Fax
(508) 856-1860
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 205001 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other practice location 1

10 Gove St
East Boston, MA 02128
Phone (617) 569-5800

Other practice location 2

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-2762

Other practice location 3

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-2665

Other practice location 4

840 Harrison Ave
Boston, MA 02118
Phone (617) 638-6610

Other identifiers 2

IdentifierTypeStateIssuer
110002970AMedicaidMA
3127828MedicaidNH

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Direct Messaging Address jmedina19482@UmassMemorial.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WA2 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
I20050202000228 MA Practitioner - Diagnostic Radiology 8123079621 Reassigns benefits to 5 organizations
I20060731000435 WA Practitioner - Diagnostic Radiology 8123079621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University Central del Caribe Escuela de Medicina, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-3000

Hospital & facility affiliations

  • Boston Medical Center-Brighton Hospital, Brighton, MA, CCN 220036
  • Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111
  • Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162
  • Heywood Hospital - Hospital, Gardner, MA, CCN 220095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205001MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Aug 30, 2019 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 28, 2012 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince May 1, 2021 Accepting new patients
BMC Affiliated Physicians, Inc. Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 8, 2023 Accepting new patients
Multicare Health System CurrentSince Jan 28, 2012 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology Past Accepting new patients
Boston University Medical Center Radiologists, Inc. Diagnostic Radiology Past Accepting new patients
Caritas Medical Group Inc. Diagnostic Radiology Past Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

960 Massachusetts Ave
Ste 2
Boston, MA 02118

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

2527 Cranberry Hwy
Wareham, MA 02571
Phone (508) 295-5556

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

55 Lake Ave N
#S2824
Worcester, MA 01655
Phone (508) 334-2710

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

4215 49th Ave NE
Tacoma, WA 98422
Phone (253) 459-7699

Interoperability endpoints

  • Direct secure messaging: jmedina19482@umassmemorial.direct-ci.com
  • Direct secure messaging: jmedina252302@direct.bmc.masshiway.net

Organizations & group practices 12

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 5

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1477520930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850",
            "fax_number": "508-856-1860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Gove St",
            "address_purpose": "LOCATION",
            "city": "East Boston",
            "state": "MA",
            "postal_code": "02128",
            "country_code": "US",
            "telephone_number": "617-569-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-2762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 N Pearl St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011794",
            "country_code": "US",
            "telephone_number": "508-427-2665",
            "fax_number": "508-427-2368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-638-6610",
            "fax_number": "617-638-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JORGE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "205001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110002970A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3127828",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N # S2-824",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmedina19482@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N # S2-824",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.