Individual provider Active NPI

Justin Kelly Stiles, M.D.

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1154632065
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
262793 Issued in MA
Practice address
1 Deaconess Rd
CC-470
Boston, MA 02215-5321
Phone
(617) 754-2733
NPI assigned
Jun 24, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 244590 MA
Anesthesiology Physician 207L00000X 262793 MA Primary

Addresses

Primary practice location

1 Deaconess Rd
CC-470
Boston, MA 02215-5321

Mailing address

1 Deaconess Rd
CC-470
Boston, MA 02215-5321

Other practice location 1

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151123001854 MA Practitioner - Anesthesiology 7810297884 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Hospital & facility affiliations

  • 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
244590MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 13, 2015 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Mar 15, 2022 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Anesthesiology CurrentSince Mar 15, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Anesthesiology CurrentSince Sep 21, 2015 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 21, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 13, 2015 Accepting new patients

Locations

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

1 Deaconess Rd
#470
Boston, MA 02215
Phone (617) 754-2700

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

Organizations & group practices 8

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 2

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": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1154632065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "CC-470",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "CC-470",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Herrick St",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019151790",
            "country_code": "US",
            "telephone_number": "978-816-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILES",
        "first_name": "JUSTIN",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "244590",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "262793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.