NPIMap

Individual provider Active NPI

Jennifer J. Vanderweele, MD

  • Family Medicine Physician
  • Dorchester, MA
National Provider Identifier
1841682127
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
286994 Issued in MA
Practice address
637 Washington Street
Dorchester, MA 02124-3510
Phone
(617) 825-9660
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 286994 MA Primary

Addresses

Primary practice location

637 Washington Street
Dorchester, MA 02124-3510

Mailing address

801 Albany Street
FL Ground
Boston, MA 02119-3791

Other practice location 1

1 Boston Medical Center Place
Dowling 5
Boston, MA 02118-2908
Phone (617) 414-4465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805003095 MA Practitioner - Family Practice 9234489691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Codman Square Health Center, IncGroup PAC ID 8123013869, 67 clinicians

Practice addresses (Care Compare)

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
286994MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Codman Square Health Center Inc CurrentSince Sep 1, 2021 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Boston University Family Medicine, Inc. Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

1 Boston Medical Ctr Pl
#1
Boston, MA 02118
Phone (617) 414-4929

1 Boston Medical Ctr Pl
#5
Boston, MA 02118
Phone (617) 414-4050

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: jvanderweele108727@direct.bmc.masshiway.net
  • Direct secure messaging: jennifer.vanderweele.1@10306.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1841682127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON STREET",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boston Medical Center Place",
            "address_2": "Dowling 5",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182908",
            "country_code": "US",
            "telephone_number": "617-414-4465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERWEELE",
        "first_name": "JENNIFER",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "286994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.