Individual provider Active NPI

Jeremy N Ford

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1992159917
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
286860 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(336) 832-7272
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 218456 NC
Diagnostic Radiology Physician 2085R0202X 286860 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, FL, NC, NJ, SC6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20220105000473 MA Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 2 organizations
I20231121001153 NH Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 1 organization
I20250924002115 FL Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 1 organization
I20251014002764 NC Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 1 organization
I20251104003108 NJ Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 1 organization
I20260123000175 SC Practitioner - Diagnostic Radiology 9739474107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians
Hartsville Medical Group LLCGroup PAC ID 7012062714, 78 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians
Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians
Colonial Family Practice LLCGroup PAC ID 9931017118, 58 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone (843) 878-1101

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

151 Everett Ave
Chelsea, MA 02150-1812
Phone (617) 884-8300

243 Charles St
Suite 1107
Boston, MA 02114-3002
Phone (617) 273-5699

29 E 29TH St
Bayonne, NJ 07002-4654
Phone (201) 858-5000

325 Broad St
Suite 100
Sumter, SC 29150-4167
Phone (803) 773-5227

335 Revolution Dr
Somerville, MA 02145-1553
Phone (857) 282-7750

385 W Wesmark Blvd
Sumter, SC 29150-1987
Phone (803) 774-8290

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

67 Corporate Dr
Suite 300
Portsmouth, NH 03801-2847
Phone (603) 610-8079

700 Medical Park Dr
Hartsville, SC 29550-4765

704 Medical Park Dr
Hartsville, SC 29550-4765
Phone (843) 332-1099

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

80 Everett Ave
Chelsea, MA 02150-2339
Phone (617) 887-3500

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218456NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Family Practice, LLC Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
Wilmington ASC LLC CurrentSince Aug 5, 2025 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Sep 24, 2021 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 1, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Sep 24, 2021 Accepting new patients
Colonial Family Practice, LLC Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
Wilmington Health PLLC CurrentSince Aug 5, 2025 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Aug 29, 2025 Accepting new patients
General Hospital Corp Current Accepting new patients
Colonial Family Practice, LLC Past Accepting new patients

Locations

2675 Winkler Ave
Ste 200
Fort Myers, FL 33901

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

325 Broad St
Ste 100
Sumter, SC 29150

674 W Liberty St
Sumter, SC 29150
Phone 80377352276010

325 Broad St
Sumter, SC 29150

Interoperability endpoints

  • Direct secure messaging: ford.jeremy.mgh@direct.partners.masshiway.net
  • Direct secure messaging: jeremy.ford.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 12

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 6

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1992159917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "336-832-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JEREMY",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "218456",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "286860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.