1. Home
  2. Directory
  3. Massachusetts
  4. Boston
  5. Family Medicine
  6. NPI Profile

THEODORE C WEATHERWAX MD
NPI 1144882879
Family Medicine - Addiction Medicine in Boston, MA

Active since July 02, 2019PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: November 23, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 23, 2022, Jul 2, 2019 (2 updates tracked since 2019).

About Theodore C Weatherwax Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE C WEATHERWAX MD (NPI 1144882879) is an individual addiction medicine provider in Boston, Massachusetts, licensed in Massachusetts (291350) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Massachusetts General Hospital, and is a graduate of University Of New Mexico School Of Medicine (2018).

NPPES Registry Identity

NPI1144882879
Entity TypeIndividualMale
Primary Taxonomy207QA0401X
Provider Legal NameTHEODORE C WEATHERWAXCredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address2209 E 32nd StTacoma, WA 98404-4922 · (253) 593-0232 · Fax (253) 593-3311
Phone(617) 726-3557
Sole ProprietorNo
Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2018
Enumeration DateJuly 2, 2019
Last NPPES UpdateNovember 23, 20222 updates tracked since enumeration
NPPES CertifiedNovember 23, 2022
✔ NPI 1144882879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in MA · 291350
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X · License MDRE.ML.60958797 (WA)
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theodore C Weatherwax Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577894096
PECOS Enrollment IDI20230630000466, I20230823001878, I20251022000172
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
17 services15 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Massachusetts General Hospital

Acute Care Hospitals · Boston, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220071
Location55 Fruit StreetBoston, MA 02114 · Suffolk County
Emergency services Birthing friendly

Phs Indian Hospital At Rosebud

Acute Care Hospitals · Rosebud, SD
OwnershipGovernment - Federal
CMS Certification Number430084
Location400 Soldier Creek RoadRosebud, SD 57570 · Todd County
Emergency services

Cascade Medical Center

Critical Access Hospitals · Leavenworth, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501313
Location817 Commercial StreetLeavenworth, WA 98826 · Chelan County
Emergency services

Astria Sunnyside Hospital

Critical Access Hospitals · Sunnyside, WA
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number501330
Location1016 Tacoma AvenueSunnyside, WA 98944 · Yakima County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Weatherwax's NPI number?

The NPI number for Theodore Weatherwax is 1144882879. It was assigned to this individual provider in the NPPES registry on July 2, 2019.

Where is Theodore Weatherwax located?

Theodore Weatherwax practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 726-3557.

What is Theodore Weatherwax's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Is Theodore Weatherwax enrolled in Medicare?

Yes. Theodore Weatherwax is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Theodore Weatherwax affiliated with any hospitals?

According to CMS data, Theodore Weatherwax is affiliated with Massachusetts General Hospital, Phs Indian Hospital At Rosebud, Cascade Medical Center and Astria Sunnyside Hospital.

When was this NPI record last updated?

The NPPES record for Theodore Weatherwax was last updated on November 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.