NPIMap

Individual provider Active NPI

Jordan D Paulson, MD

  • Neurology Physician
  • Weymouth, MA
National Provider Identifier
1619101136
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
254453 Issued in MA
Practice address
55 Fogg Rd # 105
Weymouth, MA 02190
Phone
(781) 624-8448
NPI assigned
May 12, 2009
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 18265 NH
Neurology Physician 2084N0400X 254453 MA Primary

Addresses

Primary practice location

55 Fogg Rd # 105
Weymouth, MA 02190

Mailing address

375 Boylston St
Brookline, MA 02445-6007

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

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
I20130819000068 MA Practitioner - Neurology 1759523913 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fogg Rd
South Weymouth, MA 02190-2432
Phone (781) 624-8800

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Neurology CurrentSince Jul 1, 2015 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Massachusetts General Physicians Organization Inc Neurology CurrentSince Jul 1, 2016 Accepting new patients
Angels Neurological Centers PC Neurology CurrentSince Jan 15, 2015 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

536 Washington St
Abington, MA 02351
Phone (781) 870-3773

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

75 Francis St
Boston, MA 02115

75 Francis St
#360U2
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

55 Fogg Rd
#105
Weymouth, MA 02190
Phone (781) 624-8448

Interoperability endpoints

  • Direct secure messaging: paulson.jordan.bwh@direct.partners.masshiway.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1619101136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BOYLSTON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD # 105",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "JORDAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "18265",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "254453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.