Individual provider Active NPI

Jason Edward Derek Saucedo, M.D.

  • Cardiovascular Disease Physician
  • Worcester, MA
National Provider Identifier
1528270253
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
269496 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655
Phone
(508) 334-3452
Fax
(774) 441-7657
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 269496 MA
Nuclear Cardiology Physician 207UN0901X 269496 MA
Cardiovascular Disease Physician 207RC0000X 269496 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

1 Donalds Way
East Bridgewater, MA 02333-1476
Phone (508) 941-7000

Other practice location 2

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 941-7000

Other practice location 3

25 Libby St
Brockton, MA 02302-2949
Phone (508) 941-7000

Other identifiers 1

IdentifierTypeStateIssuer
110121488AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jsaucedo272452@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20170518001928 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 1456515543 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

25 Libby St
Brockton, MA 02302-2949
Phone (508) 941-7450

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269496MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 30, 2019 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Jun 30, 2019 Accepting new patients
Physicians of Cape Cod Hospital Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

25 Libby St
Brockton, MA 02302
Phone (508) 941-7450

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

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

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: jsaucedo272452@umassmemorial.direct-ci.com

Organizations & group practices 5

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 3

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1528270253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "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": "01655",
            "telephone_number": "508-334-3452",
            "fax_number": "774-441-7657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Donalds Way",
            "address_purpose": "LOCATION",
            "city": "East Bridgewater",
            "state": "MA",
            "postal_code": "023331476",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Libby St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023022949",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAUCEDO",
        "first_name": "JASON",
        "middle_name": "EDWARD DEREK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "269496",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MA",
            "license": "269496",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "269496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110121488A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsaucedo272452@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.