Individual provider Active NPI

Jorgjeta Bukli, M.D.

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1639472863
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
246411 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-8515
Fax
(508) 334-6490
NPI assigned
Dec 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 246411 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

123 Summer St Ste 7350
Worcester, MA 01608-1216
Phone (508) 363-6849

Other practice location 2

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-8942

Other practice location 3

157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5678

Other identifiers 1

IdentifierTypeStateIssuer
110089051AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Direct Messaging Address jbukli277033@UmassMemorial.direct-ci.com

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
I20110811000335 MA Practitioner - Internal Medicine 0547439382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Massachusetts Inc Internal Medicine Current Accepting new patients
Saint Vincent Physician Services, Inc. Internal Medicine CurrentSince Jul 11, 2011 Accepting new patients
Sound Physicians of Massachusetts Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Oct 13, 2010 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 13, 2010 Accepting new patients
Sound Physicians of Massachusetts, Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients
Hot Springs MRI Center Past Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

123 Summer St
Ste 7350
Worcester, MA 01608
Phone (508) 363-6849

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

Interoperability endpoints

  • Direct secure messaging: jbukli277033@umassmemorial.direct-ci.com

Organizations & group practices 8

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": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639472863",
    "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"
        },
        {
            "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": "508-334-8515",
            "fax_number": "508-334-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Summer St Ste 7350",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-6849",
            "fax_number": "508-363-7461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-8942",
            "fax_number": "508-334-6490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521228",
            "country_code": "US",
            "telephone_number": "508-486-5678",
            "fax_number": "508-486-5677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUKLI",
        "first_name": "JORGJETA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "246411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110089051A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbukli277033@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.