NPIMap

Individual provider Active NPI

Michael Wasserman, MD

  • Neuroradiology Physician
  • Boston, MA
National Provider Identifier
1346669751
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
277865 Issued in MA
Practice address
840 Harrison Ave
Boston, MA 02118-2905
Phone
(617) 638-6610
Fax
(617) 638-6616
NPI assigned
Apr 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 277865 MA
Neuroradiology Physician 2085N0700X 277865 MA Primary

Addresses

Primary practice location

840 Harrison Ave
Boston, MA 02118-2905

Mailing address

960 Massachusetts Ave
FLR 2
Boston, MA 02118

Other practice location 1

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

Other practice location 2

10 Gove Street
East Boston, MA 02128
Phone (617) 569-5800

Other practice location 3

235 North Pearl St
Brockton, MA 02301
Phone (508) 427-2665

Other identifiers 2

IdentifierTypeStateIssuer
110107640AMedicaidMA
3117171MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514001443 MA Practitioner - Diagnostic Radiology 3870712201 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medical Associates-EbnhcGroup PAC ID 6103814371, 239 clinicians
Boston University Medical Center Radiologists, Inc.Group PAC ID 1052392768, 61 clinicians

Practice addresses (Care Compare)

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

840 Harrison Ave
Boston, MA 02118-2905
Phone (617) 638-6610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277865MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhealth Corporation CurrentSince Jul 1, 2021 Accepting new patients
Boston University Medical Center Radiologists, Inc. Neuroradiology CurrentSince Jul 1, 2021 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
BMC Affiliated Physicians, Inc. Diagnostic Radiology CurrentSince Dec 23, 2025 Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Jul 1, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2019 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: mwasserman71066@direct.bmc.masshiway.net

Organizations & group practices 6

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 8

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1346669751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FLR 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-6610",
            "fax_number": "617-638-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "02135",
            "country_code": "US",
            "telephone_number": "617-789-2762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Gove Street",
            "address_purpose": "LOCATION",
            "city": "East Boston",
            "state": "MA",
            "postal_code": "02128",
            "country_code": "US",
            "telephone_number": "617-569-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 North Pearl St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "02301",
            "country_code": "US",
            "telephone_number": "508-427-2665",
            "fax_number": "508-427-2368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "277865",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MA",
            "license": "277865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110107640A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117171",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.