NPIMap

Organization Active NPI

Steward St. Elizabeth's Medical Center of Boston, Inc.

  • Specialist
  • Boston, MA
National Provider Identifier
1174836852
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
STEWARD ST. ELIZABETH'S MEDICAL CENTER OF BOSTON, INC.
Practice address
736 Cambridge St
Boston, MA 02135-2907
Phone
(617) 789-3000
Fax
(617) 562-7241
NPI assigned
Jul 22, 2010
Last updated
Apr 2, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
STEWARD HEALTH CARE SYSTEM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Authorized official

Name
Mark J Rich
Title
Chief Financial Officer
Phone
(617) 789-2706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

736 Cambridge St
Boston, MA 02135-2907

Mailing address

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

Other names 1

  • Saint Elizabeth's Health Care (@ Brighton Marine Health Center) Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101201000677 MA Part B Supplier - Clinic/Group Practice 3476749540 Receives reassigned benefits from 36 practitioners
Practice locations: Brighton, MA

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1174836852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-3000",
            "fax_number": "617-562-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-3000",
            "fax_number": "617-562-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWARD ST. ELIZABETH'S MEDICAL CENTER OF BOSTON, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEWARD HEALTH CARE SYSTEM LLC",
        "enumeration_date": "2010-07-22",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "617-789-2706"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Elizabeth's Health Care (@ Brighton Marine Health Center)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.