Active NPI
Jacqueline L Wellman, M.D.
- Diagnostic Radiology Physician
- Marlborough, MA
National Provider Identifier
1912000332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 50994
- Practice address
- 157 Union St
Marlborough Hospital
Marlborough, MA 01752-1228 - Phone
- (774) 261-0177
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 50994 | MA | Primary |
Addresses
Primary practice location
157 Union St
Marlborough Hospital
Marlborough, MA 01752-1228
Mailing address
67 Coolidge Cir
Northborough, MA 01532-1127
Phone (508) 393-9292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FX9902 | Other | MA | MA MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milford Imaging, Inc. | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363564800000",
"number": "1912000332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 COOLIDGE CIR",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015321127",
"telephone_number": "508-393-9292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 UNION ST",
"address_2": "MARLBOROUGH HOSPITAL",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017521228",
"telephone_number": "774-261-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLMAN",
"first_name": "JACQUELINE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2013-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "50994",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA MEDICARE",
"identifier": "FX9902",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.