Individual provider Active NPI

Runna Fayez Moussa-Pervane, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1215190087
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233262 Issued in MA
Practice address
165 Dartmouth St
Internal Medicine
Boston, MA 02116-5123
Phone
(617) 859-5101
Fax
(617) 859-5050
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233262 MA Primary

Addresses

Primary practice location

165 Dartmouth St
Internal Medicine
Boston, MA 02116-5123

Mailing address

165 Dartmouth St
Internal Medicine
Boston, MA 02116-5123
Phone (617) 859-5101

Other identifiers 1

IdentifierTypeStateIssuer
110087154AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmoussapervanemd24144@direct.atrius.masshiway.net

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
I20101027000010 MA Practitioner - Internal Medicine 5193919801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

142 Berkeley St
Boston, MA 02116-5100
Phone (617) 859-5000

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233262MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Internal Medicine CurrentSince Oct 1, 2010 Accepting new patients
Atrius Health, Inc. Internal Medicine Current Accepting new patients
Atrius Health, Inc. Internal Medicine Past Accepting new patients

Locations

142 Berkeley St
Ste 4
Boston, MA 02116

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

165 Dartmouth St
Boston, MA 02116
Phone (617) 859-5000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

Interoperability endpoints

  • Direct secure messaging: rmoussapervanemd24144@direct.atrius.masshiway.net

Organizations & group practices 3

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 1

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1215190087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 DARTMOUTH ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165123",
            "telephone_number": "617-859-5101",
            "fax_number": "617-859-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 DARTMOUTH ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165123",
            "telephone_number": "617-859-5101",
            "fax_number": "617-859-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSA-PERVANE",
        "first_name": "RUNNA",
        "middle_name": "FAYEZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110087154A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmoussapervanemd24144@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "165 Dartmouth St",
            "address_2": "Internal Medicine",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021165123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.