Active NPI
Todd Andrew Jaffe, MD
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1750879458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 724-4133
- NPI assigned
- Apr 27, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 00 | MA | |
| Emergency Medicine Physician | 207P00000X | TBD | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
125 Nashua St Ste 260
Boston, MA 02114-1109
Phone (617) 724-4133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.24 of 100
- Quality
- 75.4
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.91 of 100
- Quality
- 73.58
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.13
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TBD | MA | MD | General Practice Dentistry |
| MD476310 | PA | MD | Emergency Medicine Physician |
| 00 | MA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Mep Health, LLC | Emergency Medicine | Current | Accepting new patients |
| University of Penn-Medical Group | Current | Accepting new patients |
Locations
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
Interoperability endpoints
- tjaffe1175188@meritus.direct-ci.net
Organizations & group practices 4
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.
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- NPI 1396133559
-
- Surgical Oncology Physician
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- NPI 1871981985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1750879458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 NASHUA ST STE 260",
"city": "BOSTON",
"state": "MA",
"postal_code": "021141109",
"telephone_number": "617-724-4133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-724-4133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "TODD",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-27",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "00",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "TBD",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Apr 27, 2018; 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.