NPIMap

Organization Active NPI

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

Doing business as Emergency Medicine - HMFP at BIDMC

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1316987993
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
Doing business as
Emergency Medicine - HMFP at BIDMC
Practice address
330 Brookline Ave
Boston, MA 02215
Phone
(617) 632-7441
Fax
(617) 754-2350
NPI assigned
Jun 8, 2006
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Dr. Alexandra Boer Kimball, MDNPI 1073503603
Title
Chief Executive Officer
Phone
(617) 632-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215

Mailing address

375 Longwood Ave Ste 3
Boston, MA 02215-5395
Phone (617) 632-7441

Other names 1

  • Emergency Medicine - HMFP at BIDMC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000227 MA Part B Supplier - Clinic/Group Practice 4486567104 Receives reassigned benefits from 278 practitioners
Practice locations: Boston, MA; Needham, MA; Dedham, MA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Harvard Medical Faculty Physicians29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1 Brookline Ave
Boston, MA 02215
Phone (617) 278-8100

1 Brookline Ave
Ste 230
Boston, MA 02215

1 Deaconess Rd
#111W
Boston, MA 02215

1 Deaconess Rd
Ste WCC2
Boston, MA 02215

1340 Boylston St
Fl 4
Boston, MA 02215

330 Brookline Ave
#203
Boston, MA 02215
Phone (617) 667-3364

330 Brookline Ave
Ofc
Boston, MA 02215
Phone (617) 632-8000

330 Brookline Ave
Ste FN202
Boston, MA 02215

114 North Beacon St
#116
Brighton, MA 02135
Phone (617) 783-5200

114 North Beacon St
Ste 116
Brighton, MA 02135

25 Boylston St
#L3
Chestnut Hill, MA 02467
Phone (508) 871-2000

40 Allied Dr
Ste 100
Dedham, MA 02026

115 Lincoln St
#3
Framingham, MA 01702
Phone (508) 383-1436

57 Bedford St
Lexington, MA 02420
Phone (781) 541-5111

100 Highland St
Ste 202
Milton, MA 02186
Phone (617) 898-0898

100 Highland St
Ste 221
Milton, MA 02186
Phone (617) 632-7500

272 Chestnut St
Needham, MA 02492
Phone (781) 433-0214

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

1135 Tremont St
Fl 6
Roxbury Crossing, MA 02120

Practitioners & affiliated clinicians

Practitioners 3,076

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 3,076

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1316987993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LONGWOOD AVE STE 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155395",
            "telephone_number": "617-632-7441",
            "fax_number": "617-632-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-632-7441",
            "fax_number": "617-754-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "BOER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-632-7441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Medicine - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emergency Medicine - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 21, 2024; 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.