NPIMap

Organization Active NPI

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1154435915
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
78636 Issued in MA
Legal business name
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
Practice address
330 Brookline Ave # E/TCC-2
Boston, MA 02215
Phone
(617) 667-3940
NPI assigned
Aug 18, 2006
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Ms. Sharon Gates, NPNPI 1417192303
Title
Nurse Practitioner
Phone
(617) 667-3940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 78636 MA Primary

Addresses

Primary practice location

330 Brookline Ave # E/TCC-2
Boston, MA 02215

Mailing address

Orthopaedic Surgery 330 Brookline Ave, E/TCC-2
Boston, MA 02215

National Provider Directory

National Provider Directory
Tax ID family
Harvard Medical Faculty Physicians29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1154435915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ORTHOPAEDIC SURGERY 330 BROOKLINE AVE, E/TCC-2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE # E/TCC-2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "617-667-3940",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "78636",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.