Theodore C Weatherwax, MD - Medicare Family Medicine in Boston, MA

Theodore C Weatherwax, MD is a medicare enrolled "Family Medicine - Addiction Medicine" physician in Boston, Massachusetts. His current practice location is 55 Fruit St, Boston, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (617) 726-3557.

Theodore C Weatherwax is licensed to practice in Massachusetts (license number 291350) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1144882879.

Contact Information

Theodore C Weatherwax, MD
55 Fruit St,
Boston, MA 02114-2621
(617) 726-3557
Not Available



Physician's Profile

Full NameTheodore C Weatherwax
GenderMale
SpecialityFamily Medicine - Addiction Medicine
Location55 Fruit St, Boston, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1144882879
  • Provider Enumeration Date: 07/02/2019
  • Last Update Date: 11/23/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3577894096
  • Enrollment ID: I20230630000466

Medical Identifiers

Medical identifiers for Theodore C Weatherwax such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144882879NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine MDRE.ML.60958797 (Washington)Secondary
207QA0401XFamily Medicine - Addiction Medicine 291350 (Massachusetts)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Theodore C Weatherwax allows following entities to bill medicare on his behalf.
Entity NameMassachusetts General Physicians Organization Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801874573
PECOS PAC ID: 2466365820
Enrollment ID: O20031111000434

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Entity NameThe General Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023049236
PECOS PAC ID: 6507803806
Enrollment ID: O20080313000351

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodore C Weatherwax is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Theodore C Weatherwax, MD
2209 E 32nd St,
Tacoma, WA 98404-4922

Ph: (253) 593-0232
Theodore C Weatherwax, MD
55 Fruit St,
Boston, MA 02114-2621

Ph: (617) 726-3557

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Family Medicine Doctors in Boston, MA

Lidya H Wlasiuk, M.D.
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Practice Location: 850 Harrison Ave, Yacc 5, Boston, MA 02118
Phone: 617-414-2080    Fax: 617-414-2090
Brian R Penti, M.D.
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Practice Location: 850 Harrison Ave, Yacc 4, Boston, MA 02118
Phone: 617-414-2080    Fax: 617-414-2090
Alysia L Green, MD
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Practice Location: 915 Commonwealth Ave Rear, Boston, MA 02215
Phone: 617-358-3400    Fax: 617-358-3710
Shahnaz Rahman,
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Practice Location: 820 Harrison Ave, Boston, MA 02118
Phone: 404-259-4008    
Dr. Amy Min He, MD
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Practice Location: 637 Washington St, Boston, MA 02124
Phone: 617-825-9660    
Katherine A Gergen Barnett, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 11 Melnea Cass Blvd, Boston, MA 02119
Phone: 617-414-2080    Fax: 617-414-2090
Dr. Xiangxin Chen, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 145 South St, Boston, MA 02111
Phone: 617-482-7555    Fax: 617-482-2930

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