Boston Body Evolution LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

245841 Issued in MA

Legal business name

BOSTON BODY EVOLUTION LLC

Practice address

1290 Boylston Street
Chestnut Hill, MA 02467

Phone

(617) 396-7899

Fax

(212) 253-4039

NPI assigned

May 17, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Nguyen, MD

Title

Authorized Official

Phone

(617) 396-7899

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1033566328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BOYLSTON STREET",
            "city": "CHESTNUT",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-396-7899",
            "fax_number": "212-253-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 BOYLSTON STREET",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-396-7899",
            "fax_number": "212-253-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON BODY EVOLUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "617-396-7899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "245841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "245841",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Jean Boecher, MSN, RN,CS
• Kristo Bolano, OD
• Emily Borland, APRN
• Joanne Pansa Bosch, PT
• Claire Boskin, MSW
• Boston Orthopedic Spine Care Inc
• Boston Reproductive Medicine Physician Group PPLC
• Boston Reproductive Medicine Physician Group PPLC
• Boston Reproductive Medicine Physician Group PPLC
• Boston Reproductive Medicine Physician Group PPLC

• Specialist in Chestnut Hill, MA
• Providers in Chestnut Hill, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.