Individual provider Active NPI

Todd Andrew Jaffe, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1750879458
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
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

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220714003047 PA Practitioner - Emergency Medicine 5092064535 Reassigns benefits to 1 organization
I20240415001693 DC Practitioner - Emergency Medicine 5092064535 Reassigns benefits to 1 organization
I20250116002614 MD Practitioner - Emergency Medicine 5092064535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
75.4
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
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

LicenseStateTypeSpecialty
TBDMAMDGeneral Practice Dentistry
MD476310PAMDEmergency Medicine Physician
00MAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Apr 9, 2024 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.