Individual provider Active NPI

Archana Vasudevan, DO

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1053738286
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
272178 Issued in MA
Practice address
801 Massachusetts Ave
Crosstown 2
Boston, MA 02118-0211
Phone
(617) 414-7399
Fax
(617) 414-9201
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 272178 MA Primary
Internal Medicine Physician 207R00000X 06186 KY
Hospitalist Physician 208M00000X 272178 MA

Addresses

Primary practice location

801 Massachusetts Ave
Crosstown 2
Boston, MA 02118-0211

Mailing address

801 Albany St FL Ground
Boston, MA 02119-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, KY2 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
I20170803000241 MA Practitioner - HospitalistPractitioner - Internal Medicine 0840417937
I20251118003587 KY Practitioner - Internal Medicine 0840417937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Valley Hospital Medicine Physicians LLCGroup PAC ID 3779973839, 27 clinicians

Practice addresses (Care Compare)

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 444-2444

Hospital & facility affiliations

  • Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
  • Preston Memorial Hospital Hospital, Kingwood, WV, CCN 511312
  • Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
  • Lourdes Rehabilitation Center Inpatient rehabilitation facility, Paducah, KY, CCN 18T102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06186KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Hospital Medicine Physicians, LLC Internal Medicine CurrentSince Sep 18, 2025 Accepting new patients
Mercy Health-Lourdes Hospital LLC Past Accepting new patients
Boston Medical Center Corporation Past Accepting new patients

Locations

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1053738286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021192560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE",
            "address_2": "CROSSTOWN 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021180211",
            "telephone_number": "617-414-7399",
            "fax_number": "617-414-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASUDEVAN",
        "first_name": "ARCHANA",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "272178",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "06186",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "272178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.