Individual provider Active NPI

Jonathan Louis Harris, P.A.-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1831596675
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5221 Issued in MA
Practice address
780 Albany St
Boston, MA 02118-2524
Phone
(857) 654-1000
Fax
(857) 654-1100
NPI assigned
Nov 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA5221 MA Primary

Addresses

Primary practice location

780 Albany St
Boston, MA 02118-2524

Mailing address

780 Albany St
Boston, MA 02118-2524
Phone (857) 654-1000

Other practice location 1

1 Boston Medical Ctr Pl # 1N64
Boston, MA 02118-2908
Phone (617) 414-4580

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624002345 MA Practitioner - Physician Assistant 8820309388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Health Care for the Homeless Program, Inc.Group PAC ID 2668475419, 75 clinicians

Practice addresses (Care Compare)

444 Harrison Ave
Boston, MA 02118-2404
Phone (857) 654-1850

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Dec 8, 2014 Accepting new patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Dec 8, 2014 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

780 Albany St
Boston, MA 02118
Phone (857) 654-1000

780 Albany St
#2130
Boston, MA 02118

Interoperability endpoints

  • Direct secure messaging: jharris188700@direct.ochin.org
  • Direct secure messaging: jharris83028@direct.bmc.masshiway.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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1831596675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182524",
            "telephone_number": "857-654-1000",
            "fax_number": "857-654-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182524",
            "telephone_number": "857-654-1000",
            "fax_number": "857-654-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boston Medical Ctr Pl # 1N64",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182908",
            "country_code": "US",
            "telephone_number": "617-414-4580",
            "fax_number": "617-414-4572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JONATHAN",
        "middle_name": "LOUIS",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-21",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.