NPIMap

Individual provider Active NPI

Jorge Fernando Tello, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1497080048
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A115100 Issued in CA
Practice address
294 Washington St
Suite 210
Boston, MA 02108-4634
Phone
(617) 728-6000
NPI assigned
Oct 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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
Internal Medicine Physician 207R00000X A115100 CA Primary

Addresses

Primary practice location

294 Washington St
Suite 210
Boston, MA 02108-4634

Mailing address

630 Adams St
Milton, MA 02186-5631
Phone (617) 216-8605

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
I20121022000081 MA Practitioner - Internal Medicine 7618127036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115100CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Sep 13, 2012 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Sep 13, 2012 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

294 Washington St
Ste 210
Boston, MA 02108
Phone (617) 724-3313

Interoperability endpoints

  • Direct secure messaging: tello.jorge.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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 8

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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1497080048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 ADAMS ST",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021865631",
            "telephone_number": "617-216-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 WASHINGTON ST",
            "address_2": "SUITE 210",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021084634",
            "telephone_number": "617-728-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "JORGE",
        "middle_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A115100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.