Active NPI
Michael Avery, MD, PHD
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1235717067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 110 Francis Street, Suite 9B
Lowry Medical Office Building
Boston, MA 02215 - Phone
- (617) 632-9236
- NPI assigned
- Apr 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
110 Francis Street, Suite 9B
Lowry Medical Office Building
Boston, MA 02215
Mailing address
110 Francis Street, Suite 9B
Lowry Medical Office Building
Boston, MA 02215
Phone (617) 632-9236
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210702001529 | MA | Order and Referring Only - Neurosurgery | 5597166165 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Past | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Dermatology - HMFP at BIDMC
- Dermatology Physician
- Boston, MA
- NPI 1043250616
-
dba HMFP - Surgery
- Surgery Physician
- Boston, MA
- NPI 1720037385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1235717067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 FRANCIS STREET, SUITE 9B",
"address_2": "LOWRY MEDICAL OFFICE BUILDING",
"city": "BOSTON",
"state": "MA",
"postal_code": "02215",
"telephone_number": "617-632-9236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 FRANCIS STREET, SUITE 9B",
"address_2": "LOWRY MEDICAL OFFICE BUILDING",
"city": "BOSTON",
"state": "MA",
"postal_code": "02215",
"telephone_number": "617-632-9236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "MICHAEL",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-01",
"last_updated": "2021-04-01",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.