Active NPI
Jeff Quinn Bostic, MD
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1730164005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 79481
- Practice address
- 55 Fruit St
Yaw 6900
Boston, MA 02114-2621 - Phone
- (617) 726-2724
- NPI assigned
- Dec 9, 2005
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 79481 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Yaw 6900
Boston, MA 02114-2621
Mailing address
PO Box 9142
Charlestown, MA 02129-9142
Phone (617) 724-8282
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79481 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Georgetown Medical Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Washington, DC
- NPI 1285636522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1730164005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9142",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021299142",
"telephone_number": "617-724-8282",
"fax_number": "617-726-5567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"address_2": "YAW 6900",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-2724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTIC",
"first_name": "JEFF",
"middle_name": "QUINN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "79481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.