Active NPI
Niloo M Edwards, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Boston, MA
National Provider Identifier
1083678627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 281612
- Practice address
- 732 Harrison Ave
3Rd Floor
Boston, MA 02118 - Phone
- (617) 638-5600
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 46078 | WI | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 281612 | MA | Primary |
Addresses
Primary practice location
732 Harrison Ave
3Rd Floor
Boston, MA 02118
Mailing address
801 Albany Street
FL Ground
Boston, MA 02119
Phone (617) 414-5405
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01647098 | Medicaid | NY | |
| 020028102 | Other | NY | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 281612 | MA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| The Trustees of Columbia University in the City of New York | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past | Accepting new patients |
| St. Peter'S Health Partners Medical Associates, P.C. | Past | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
920 E 1st St
Ste 301
Duluth, MN 55805
Phone (218) 279-6279
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
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.
-
- Rehabilitation Hospital Unit
- Duluth, MN
- NPI 1902845068
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Duluth, MN
- NPI 1073480968
-
- General Acute Care Hospital
- Duluth, MN
- NPI 1801835970
-
- Pediatrics Physician
- Slingerlands, NY
- NPI 1669717260
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- New York, NY
- NPI 1114083599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1083678627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 ALBANY STREET",
"address_2": "FL GROUND",
"city": "BOSTON",
"state": "MA",
"postal_code": "02119",
"telephone_number": "617-414-5405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 HARRISON AVE",
"address_2": "3RD FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-638-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "NILOO",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "WI",
"license": "46078",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MA",
"license": "281612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01647098",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020028102",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.