DR. JUSTIN MICHAEL MORTIMER (MD) – Psychiatry Physician, NPI 1013277656
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,743 PSYCHIATRY in MA
Provider Addresses for DR. JUSTIN MICHAEL MORTIMER (MD)
30 LUCILLE PL
NEWTON, MA 024641211
Phone: (860) 833-2797
Type: Mailing
12 ALFRED ST STE 200
WOBURN, MA 018011915
Phone: (781) 646-0500
Type: Location
2732 TROLLIE LN
JACKSONVILLE, FL 322113833
Phone: (904) 289-1254
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-12-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161107001735 | I | Psychiatry | MA | TBD |
| I20230526002408 | I | Psychiatry | SC | TBD |
| I20231214002585 | I | Psychiatry | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02464)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | FL | |
| General Practice | FL |
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