NPIMap

Organization Active NPI

JJM Medical Services, PC

  • Anesthesiology Physician
  • Waltham, MA
National Provider Identifier
1952548265
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
JJM MEDICAL SERVICES, PC
Practice address
1440 Main St
Waltham, MA 02451-1631
Phone
(781) 891-9300
Fax
(617) 440-2880
NPI assigned
Jan 9, 2009
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Juan J Mallari, MDNPI 1508834854
Title
President
Phone
(617) 455-2247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1440 Main St
Waltham, MA 02451-1631

Mailing address

PO Box 986520 Department 310
Boston, MA 02298-6520
Phone (207) 784-2554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY, VT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20090128000435 MA Part B Supplier - Clinic/Group Practice 6800950312 Receives reassigned benefits from 91 practitioners
Practice locations: Worcester, MA; Weymouth, MA; Milford, MA; West Springfield, MA; Waltham, MA; Peabody, MA; Raynham, MA; Beverly, MA…
O20110608000610 NY Part B Supplier - Clinic/Group Practice 6800950312 Receives reassigned benefits from 42 practitioners
Practice locations: Amsterdam, NY; Latham, NY; Wilton, NY
O20150303002045 VT Part B Supplier - Clinic/Group Practice 6800950312 Receives reassigned benefits from 3 practitioners
Practice locations: South Burlington, VT

National Provider Directory

National Provider Directory

Locations

900 Cummings Ctr
Ste 122U
Beverly, MA 01915
Phone (978) 922-4670

171 Interstate Dr
Ste 101
West Springfield, MA 01089
Phone (413) 737-5500

Practitioners & affiliated clinicians

Practitioners 122

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 122

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1952548265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986520 DEPARTMENT 310",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986520",
            "telephone_number": "207-784-2554",
            "fax_number": "207-777-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511631",
            "telephone_number": "781-891-9300",
            "fax_number": "617-440-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJM MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MALLARI",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-455-2247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.