NPIMap

Organization Active NPI

Boston Reproductive Medicine Physician Group PPLC

  • Clinical Medical Laboratory
  • Chestnut Hill, MA
National Provider Identifier
1366076572
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
BOSTON REPRODUCTIVE MEDICINE PHYSICIAN GROUP PPLC
Practice address
300 Boylston St Ste 300
Chestnut Hill, MA 02467-1976
Phone
(617) 449-9750
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Matt Tyson
Title
Director, Managed Care Contracting
Phone
(615) 477-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

300 Boylston St Ste 300
Chestnut Hill, MA 02467-1976

Mailing address

300 Boylston St Ste 300
Chestnut Hill, MA 02467-1976
Phone (617) 449-9750

Other identifiers 1

IdentifierTypeStateIssuer
22D2125498OtherCLIA

Other names 1

  • CCRM Boston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Boston Reproductive Medicine Physician Group PPLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1366076572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 300",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671976",
            "telephone_number": "617-449-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 300",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671976",
            "telephone_number": "617-449-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON REPRODUCTIVE MEDICINE PHYSICIAN GROUP PPLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "615-477-6677"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "22D2125498",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCRM Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.