Individual provider Active NPI

Julie L Wentworth, N.P.

  • Gerontology Nurse Practitioner
  • Boston, MA
National Provider Identifier
1487719951
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
271026 Issued in MA
Practice address
850 Harrison Ave
Yacc, 3Rd Floor
Boston, MA 02118-4001
Phone
(617) 638-6100
Fax
(617) 638-6179
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 271026 MA Primary

Addresses

Primary practice location

850 Harrison Ave
Yacc, 3Rd Floor
Boston, MA 02118-4001

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118

Other identifiers 1

IdentifierTypeStateIssuer
110074615AMedicaidMA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070221000350 MA Practitioner - Nurse Practitioner 7315049376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Perelman School of Med at the University of Pennsylvania, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1611 Cambridge St
Cambridge, MA 02138-4302
Phone (617) 661-5500

Hospital & facility affiliations

  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
271026MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Current Accepting new patients
The General Hospital Corporation CurrentSince Mar 1, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Mar 1, 2020 Accepting new patients
Atrius Health, Inc. CurrentSince Jun 22, 2015 Accepting new patients

Locations

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

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

55 Fruit St
Boston, MA 02114

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

1611 Cambridge St
Cambridge, MA 02138
Phone (617) 661-5100

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 1

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1487719951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC, 3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-638-6100",
            "fax_number": "617-638-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "271026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110074615A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.