MEDICARE: DR. JONATHAN SAMUEL HAUSMANN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	248865	MA
2	207R00000X	Internal Medicine Physician	248865	MA
3	208000000X	Pediatrics Physician	248865	MA
4	2080P0216X	Pediatric Rheumatology Physician	248865	MA

General Provider Information

NPI Number	:	1932367562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN SAMUEL HAUSMANN MD

Provider Business Mailing Address
First Line	:	243 CONCORD AVE APT 9
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-1360
Country	:	US
Telephone Number	:	617-871-0040
Fax Number	:	888-531-3853

Provider Business Practice Location Address
First Line	:	243 CONCORD AVE APT 9
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-1360
Country	:	US
Telephone Number	:	617-871-0040
Fax Number	:	888-531-3853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	06/11/2026

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