Individual provider Active NPI

Alexey Makogonov, MD

  • Internal Medicine Physician
  • Beverly, MA
National Provider Identifier
1417944877
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151220 Issued in MA
Practice address
85 Herrick St
Beverly, MA 01915-1776
Phone
(978) 922-3000
NPI assigned
Sep 30, 2005
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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 151220 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly, MA 01915-1776

Mailing address

Beverly Hospital
85 Herrick Street
Beverly, MA 01915-1790
Phone (978) 922-3000

Other identifiers 1

IdentifierTypeStateIssuer
3157130MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080926000008 MA Practitioner - Internal MedicinePractitioner - Other (Physician) 0648347070 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

29 Mall Rd
Burlington, MA 01805-0001

298 Washington St
Addison Gilbert
Gloucester, MA 01930-4832
Phone (978) 283-4000

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 1, 2025 Accepting new patients
Seacoast Affiliated Group Practice, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Northeast Hospital Corporation Past Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients

Locations

100 Cummings Ctr
Ste 408J
Beverly, MA 01915
Phone (978) 524-9950

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8085

21 Highland Ave
Ste 5
Newburyport, MA 01950
Phone (978) 255-4217

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: amakogonov33460@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1417944877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEVERLY HOSPITAL",
            "address_2": "85 HERRICK STREET",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151776",
            "telephone_number": "978-922-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOGONOV",
        "first_name": "ALEXEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157130",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.