Jasmine Outlaw, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Boston, Massachusetts. Her current practice location is
55 Fruit St, Boston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(617) 726-2000.
Jasmine Outlaw is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235711219.
Physician's Profile
Full Name | Jasmine Outlaw |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 55 Fruit St, Boston, Massachusetts |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1235711219
- Provider Enumeration Date: 04/28/2021
- Last Update Date: 01/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 6901208941
- Enrollment ID: I20210713001791
Medical Identifiers
Medical identifiers for Jasmine Outlaw such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235711219 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 1016262 (Massachusetts) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Jasmine Outlaw 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 Address | Practice Location Address |
Jasmine Outlaw, MD 2 Bowdoin St Apt 518, Everett, MA 02149-2459 Ph: (215) 520-0015 | Jasmine Outlaw, MD 55 Fruit St, Boston, MA 02114-2621 Ph: (617) 726-2000 |
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