Active NPI
Jennifer Kodela, DO
- Pulmonary Disease Physician
- Worcester, MA
National Provider Identifier
1750813689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 288753
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 334-1975
- NPI assigned
- Mar 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 288753 | MA | |
| Pulmonary Disease Physician | 207RP1001X | 288753 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other practice location 1
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110126023A | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkodela28743@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
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
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000
Hospital & facility affiliations
- Umass Memorial Medical Center/University Campus
- Umass Memorial Health - Harrington Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 288753 | MA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Center, Inc. | Past | Accepting new patients |
Interoperability endpoints
- jkodela28743@umassmemorial.direct-ci.com
Organizations & group practices 2
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
- Worcester, MA
- NPI 1760445373
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southbridge, MA
- NPI 1790780047
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1750813689",
"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",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"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": "508-334-1975"
}
],
"practiceLocations": [
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-334-1975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KODELA",
"first_name": "JENNIFER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-30",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MA",
"license": "288753",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MA",
"license": "288753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110126023A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkodela28743@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.