Individual provider Active NPI

Timothy Frey, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1053467969
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
59953 Issued in MA
Practice address
736 Cambridge St
Department of Radiology
Boston, MA 02135-2907
Phone
(617) 789-2740
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 59953 MA Primary

Addresses

Primary practice location

736 Cambridge St
Department of Radiology
Boston, MA 02135-2907

Mailing address

736 Cambridge St
Department of Radiology
Boston, MA 02135-2907
Phone (617) 789-2740

Other practice location 1

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-3275

Other identifiers 1

IdentifierTypeStateIssuer
3045668MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051105000146 MA Practitioner - Interventional RadiologyPractitioner - Diagnostic RadiologyPractitioner - Emergency Medicine 5395763643 Reassigns benefits to 3 organizations
I20210209002204 TX Practitioner - Diagnostic Radiology 5395763643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
State University of New York at Buffalo School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

2175 State Rd
Suite 4
Pinon, AZ 86510-2147
Phone (928) 725-9000

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Navajo Route 64 and 12
Tsaile, AZ 86556-0467
Phone (928) 724-3600

PO Box PH
Chinle, AZ 86503-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Radiology Associates, Inc. Diagnostic Radiology CurrentSince Mar 1, 2013 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Apr 2, 2024 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Jan 25, 2021 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients

Locations

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

110 Liberty St
Brockton, MA 02301

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

10 Little Brook Rd
West Wareham, MA 02576

Interoperability endpoints

  • Direct secure messaging: timothy.frey@direct.signature.masshiway.net
  • Direct secure messaging: tfrey27681@direct.bilh.masshiway.net

Organizations & group practices 5

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 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1053467969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-565-3275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREY",
        "first_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "59953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045668",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.