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DR. AMY JORDAN WISDOM
NPI 1275119612
Radiology - Radiation Oncology in Boston, MA

Active since March 23, 2021PECOS Enrolled

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2026, Mar 23, 2021 (2 updates tracked since 2021).

About Dr. Amy Jordan Wisdom NPPES

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

DR. AMY JORDAN WISDOM (NPI 1275119612) is an individual radiation oncology provider in Boston, Massachusetts, licensed in Massachusetts (1022845) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Boston, and is a graduate of Duke University School Of Medicine (2021).

NPPES Registry Identity

NPI1275119612
Entity TypeIndividualFemale
Primary Taxonomy2085R0001X
Provider Legal NameDR. AMY JORDAN WISDOM
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address55 Fruit StBoston, MA 02114-2621 · (617) 665-1000
Phone(617) 665-1000
Sole ProprietorNo
Medical School CMSDuke University School Of MedicineGraduated 2021
Enumeration DateMarch 23, 2021
Last NPPES UpdateMarch 20, 20262 updates tracked since enumeration
NPPES CertifiedMarch 20, 2026
✔ NPI 1275119612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Radiation OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0001X
License✔ Licensed in MA · 1022845
Definition
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 175 Francis StBoston, MA 02115-6110 · Phone (617) 732-5500

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Amy Jordan Wisdom is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406255983
PECOS Enrollment IDI20260325004024
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.

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
$189.86 typical visit price
range $63.72 – $189.86
Typical copayment $47.46 (range $15.93 – $47.46)
Most-billed visit code 99205
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
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 Amy Wisdom's NPI number?

The NPI number for Amy Wisdom is 1275119612. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Where is Amy Wisdom located?

Amy Wisdom practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 665-1000.

What is Amy Wisdom's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Radiation Oncology, with taxonomy code 2085R0001X.

Is Amy Wisdom enrolled in Medicare?

Yes. Amy Wisdom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amy Wisdom was last updated on March 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.