NPIMap

Individual provider Active NPI

Olga Beresneva, M.D.

  • Colon & Rectal Surgery Physician
  • Boston, MA
National Provider Identifier
1114345741
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
281960 Issued in MA
Practice address
725 Albany Street, Suite 6B
Shapiro BLDG.
Boston, MA 02118
Phone
(617) 414-8054
Fax
(617) 414-8055
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 281960 MA Primary
Surgery Physician 208600000X 281960 MA

Addresses

Primary practice location

725 Albany Street, Suite 6B
Shapiro BLDG.
Boston, MA 02118

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

11 Nevins St
Suite 201
Brighton, MA 02135
Phone (617) 789-2442

Other practice location 2

1 Pearl Street
Suite 2000
Brockton, MA 02301
Phone (617) 508-4104

Other identifiers 2

IdentifierTypeStateIssuer
3124180MedicaidNH
110109294AMedicaidMA

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
I20200813003318 MA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 2163641044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Drexel University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston University General Surgical Associates, Inc.Group PAC ID 9830183763, 86 clinicians
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8605

11 Nevins St
Brighton, MA 02135-3514
Phone (617) 779-6700

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

732 Harrison Ave
Boston, MA 02118-2309

732 Harrison Ave FL 3
Preston BLDG
Boston, MA 02118-2309
Phone (617) 638-7350

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-3000

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281960MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University General Surgical Associates, Inc. Surgery CurrentSince Sep 1, 2020 Accepting new patients
BMC Affiliated Physicians, Inc. Surgery CurrentSince Nov 1, 2025 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Sep 1, 2020 Accepting new patients

Locations

88 Newton St
#C515
Boston, MA 02118
Phone (617) 638-8409

960 Massachusetts Ave
Ste 2
Boston, MA 02118

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

725 Albany St
Ste 6B
Boston, MA 02118
Phone (617) 414-8054

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Ste 2000
Brockton, MA 02301
Phone (508) 584-4104

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

Interoperability endpoints

  • Direct secure messaging: oberesneva71006@direct.bmc.masshiway.net

Organizations & group practices 4

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 8

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1114345741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY STREET, SUITE 6B",
            "address_2": "SHAPIRO BLDG.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-8054",
            "fax_number": "617-414-8055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Nevins St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "02135",
            "country_code": "US",
            "telephone_number": "617-789-2442",
            "fax_number": "617-202-4349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Pearl Street",
            "address_2": "Suite 2000",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "02301",
            "country_code": "US",
            "telephone_number": "617-508-4104",
            "fax_number": "617-584-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERESNEVA",
        "first_name": "OLGA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MA",
            "license": "281960",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "281960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3124180",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110109294A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.