Active NPI
Julian Wise, MD
- Student in an Organized Health Care Education/Training Program
- Jamaica Plain, MA
National Provider Identifier
1669319562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 3021434
- Practice address
- 170 Morton St
Jamaica Plain, MA 02130-3735 - Phone
- (617) 522-8110
- NPI assigned
- Apr 30, 2026
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 3021434 | MA | Primary |
Addresses
Primary practice location
170 Morton St
Jamaica Plain, MA 02130-3735
Mailing address
170 Morton St
Boston, MA 02130-3735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3021434 | MA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1669319562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 MORTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 MORTON ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303735",
"telephone_number": "617-522-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "JULIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-30",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "3021434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.