Individual provider Active NPI

Jennifer Setlur, M.D.

  • Pediatric Otolaryngology Physician
  • Concord, MA
National Provider Identifier
1679736110
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
260247 Issued in MA
Practice address
54 Baker Avenue Ext
Suite 303
Concord, MA 01742-2137
Phone
(978) 369-8780
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 260247 MA Primary
Otolaryngology Physician 207Y00000X 260247 MA

Addresses

Primary practice location

54 Baker Avenue Ext
Suite 303
Concord, MA 01742-2137

Mailing address

54 Baker Avenue Ext
Ste 303
Concord, MA 01742-2137
Phone (978) 369-8780

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
I20141103001836 MA Practitioner - Otolaryngology 9739301946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Eye and Ear Associates, IncGroup PAC ID 4486540275, 430 clinicians

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260247MAMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology CurrentSince Mar 1, 2016 Accepting new patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology Past Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

54 Baker Avenue Ext
Ste 303
Concord, MA 01742
Phone (978) 369-8780

300 Crown Colony Dr
Ste 201
Quincy, MA 02169
Phone (617) 573-3135

Interoperability endpoints

  • Direct secure messaging: setlur.jennifer.meei@direct.partners.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1679736110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BAKER AVENUE EXT",
            "address_2": "STE 303",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422137",
            "telephone_number": "978-369-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 BAKER AVENUE EXT",
            "address_2": "SUITE 303",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422137",
            "telephone_number": "978-369-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETLUR",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MA",
            "license": "260247",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "260247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.