NPIMap

Organization Active NPI

Beth Israel Deaconess Medical Center

  • Radiology Clinic/Center
  • Boston, MA
National Provider Identifier
1215977442
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
153967 Issued in MA
Legal business name
BETH ISRAEL DEACONESS MEDICAL CENTER
Practice address
330 Brookline Ave
CCW 308
Boston, MA 02215-5400
Phone
(617) 754-2598
Fax
(617) 754-2754
NPI assigned
Jun 7, 2006
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Dr. S. Nahum Goldberg, MD
Title
Staff Radiologist
Phone
(617) 754-2598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 153967 MA Primary

Addresses

Primary practice location

330 Brookline Ave
CCW 308
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
CCW 308
Boston, MA 02215-5400
Phone (617) 754-2598

Other identifiers 1

IdentifierTypeStateIssuer
3166902MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Beth Israel Hosp Home C18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

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": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1215977442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "CCW 308",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-754-2598",
            "fax_number": "617-754-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "CCW 308",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-754-2598",
            "fax_number": "617-754-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH ISRAEL DEACONESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "S. NAHUM",
        "authorized_official_title_or_position": "STAFF RADIOLOGIST",
        "authorized_official_telephone_number": "617-754-2598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MA",
            "license": "153967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3166902",
            "state": "MA"
        }
    ],
    "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 Oct 29, 2007; 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.