NPIMap

Individual provider Active NPI

Devasena Balasubramaniam, M.D.

  • Internal Medicine Physician
  • Waltham, MA
National Provider Identifier
1396936498
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233639 Issued in MA
Practice address
40 Second Ave
Mass General West
Waltham, MA 02451
Phone
(781) 487-4350
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233639 MA Primary

Addresses

Primary practice location

40 Second Ave
Mass General West
Waltham, MA 02451

Mailing address

31 Fletcher Ave
Unit 7
Lexington, MA 02420-3700
Phone (781) 862-0943

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
I20070919000861 MA Practitioner - Internal Medicine 6406940550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Beth Israel Lahey Health at Home Home health agency, Beverly, MA, CCN 227495
  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Caretenders Home health agency, Needham Heights, MA, CCN 227269
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233639MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Sep 6, 2007 Accepting new patients
The General Hospital Corporation CurrentSince Sep 6, 2007 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

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

55 Fruit St
Boston, MA 02114

52 Second Ave
Ste 400
Waltham, MA 02451
Phone (781) 487-4340

Interoperability endpoints

  • Direct secure messaging: balasubramaniam.devasena.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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 9

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1396936498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 FLETCHER AVE",
            "address_2": "UNIT 7",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024203700",
            "telephone_number": "781-862-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SECOND AVE",
            "address_2": "MASS GENERAL WEST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "781-487-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASUBRAMANIAM",
        "first_name": "DEVASENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.