NPIMap

Individual provider Active NPI

Molly Linn Perencevich, M.D.

  • Gastroenterology Physician
  • Boston, MA
National Provider Identifier
1043366214
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
236362 Issued in MA
Practice address
75 Francis St
Brigham and Women'S Hospital, Department of Medicine
Boston, MA 02115-6110
Phone
(617) 732-5775
NPI assigned
Jan 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 228772 MA
Gastroenterology Physician 207RG0100X 236362 MA Primary

Addresses

Primary practice location

75 Francis St
Brigham and Women'S Hospital, Department of Medicine
Boston, MA 02115-6110

Mailing address

32 Spring Park Ave
Unit #2
Jamaica Plain, MA 02130-2132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000480 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 7517098569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Harvard Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Upper gastrointestinal (GI) endoscopy for acid reflux17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
228772MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women'S Hospital Current Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • Direct secure messaging: perencevich.molly.bwh@direct.partners.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1043366214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SPRING PARK AVE",
            "address_2": "UNIT #2",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "BRIGHAM AND WOMEN'S HOSPITAL, DEPARTMENT OF MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERENCEVICH",
        "first_name": "MOLLY",
        "middle_name": "LINN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "228772",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "236362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.