Organization Active NPI

Jason M. Gilbert, M.D.P.C.

  • Ophthalmology Physician
  • Medford, MA
National Provider Identifier
1801134416
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JASON M. GILBERT, M.D.P.C.
Practice address
101 Main St
Suite 208
Medford, MA 02155-4540
Phone
(781) 395-9916
NPI assigned
Jan 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Jason M. Gilbert, M.D.
Title
President
Phone
(781) 395-9916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MA Primary

Addresses

Primary practice location

101 Main St
Suite 208
Medford, MA 02155-4540

Mailing address

101 Main Street
Suite 208
Medford, MA 02155-4530
Phone (781) 395-9916

Other identifiers 2

IdentifierTypeStateIssuer
9787267MedicaidMA
M17721OtherMAMASSACHUSETTS BLUE SHIELD PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Jason M Gilbert MDPC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 Main St
Ste 208
Medford, MA 02155
Phone (781) 395-5859

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1801134416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN STREET",
            "address_2": "SUITE 208",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-395-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 208",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-395-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON M. GILBERT, M.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-395-9916",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9787267",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS BLUE SHIELD PROVIDER NUMBER",
            "identifier": "M17721",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.