NPIMap

Individual provider Active NPI

Ella Kipervasser

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1124559240
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
290783 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 643-2009
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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 290783 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Lake Ave N
Worcester, MA 01655-0002

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
I20220708001937 MA Practitioner - Diagnostic Radiology 5092080184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Massachusetts Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Radiological Associates IncGroup PAC ID 1153387675, 16 clinicians

Practice addresses (Care Compare)

200 Unicorn Park Dr
Woburn, MA 01801-3342

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 756-2342

444 Washington St
Suite 100
Woburn, MA 01801-1072
Phone (781) 787-3003

500 Salem St
Wilmington, MA 01887-1200
Phone (978) 988-6020

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290783MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Radiological Associates, Inc. Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2022 Accepting new patients
Winchester Hospital - Shields MRI LLC CurrentSince Aug 1, 2023 Accepting new patients
Winchester Hospital - Shields MRI LLC CurrentSince Aug 1, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

444 Washington St
Ste 100
Woburn, MA 01801
Phone (781) 279-2158

Interoperability endpoints

  • Direct secure messaging: ekipervasser199535@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 6

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1124559240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPERVASSER",
        "first_name": "ELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "290783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.