Active NPI
Jorge De Avila, MD
- Family Medicine Physician
- Lawrence, MA
National Provider Identifier
1649909573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1026901
- Practice address
- 34 Haverhill St
Lawrence, MA 01841-2884 - Phone
- (978) 686-0090
- Fax
- (978) 681-5963
- NPI assigned
- Jun 7, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1026901 | MA | Primary |
Addresses
Primary practice location
34 Haverhill St
Lawrence, MA 01841-2884
Mailing address
34 Haverhill St FL 3
Lawrence, MA 01841-2884
Phone (978) 686-0090
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220707002225 | MA | Order and Referring Only - Family Practice | 0446630479 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Chicago, Pritzker School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
34 Haverhill St
Lawrence, MA 01841-2884
Hospital & facility affiliations
- Merrimack Health Lawrence Hospital
- Northeast Rehabilitation Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- jorge.deavila.1@23857.direct.athenahealth.com
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lawrence, MA
- NPI 1750381281
-
- Rehabilitation Hospital
- Salem, NH
- NPI 1255354288
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1649909573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 HAVERHILL ST FL 3",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018412884",
"telephone_number": "978-686-0090",
"fax_number": "978-681-5963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 HAVERHILL ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018412884",
"telephone_number": "978-686-0090",
"fax_number": "978-681-5963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE AVILA",
"first_name": "JORGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-07",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "1026901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.