Individual provider Active NPI

Laura Ann Goguen, M.D.

  • Otolaryngology Physician
  • Brookline, MA
National Provider Identifier
1427036854
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
153621 Issued in MA
Practice address
111 Cypress St
Brookline, MA 02445-6002
Phone
(857) 307-0896
Fax
(617) 525-6511
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 153621 MA Primary

Addresses

Primary practice location

111 Cypress St
Brookline, MA 02445-6002

Mailing address

47 Valley Rd
Wellesley, MA 02481-1445
Phone (781) 431-2202

Other identifiers 1

IdentifierTypeStateIssuer
179426MedicaidMA

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
I20080929000297 MA Practitioner - Otolaryngology 4385711647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Human Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

45 Francis St
Boston, MA 02115-6105
Phone (617) 732-5500

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3586

450 Brookline Ave
Boston, MA 02215-5450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux18
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153621MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince May 1, 1999 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince May 1, 1999 Accepting new patients
Brigham & Womens Hospital, Inc. Past Accepting new patients
Dana-Farber Cancer Institute, Inc. Past Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

75 Francis St
Fl 2
Boston, MA 02115
Phone (617) 732-6040

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

20 Prospect St
Milford, MA 01757
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: goguen.laura.bwh@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1427036854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 VALLEY RD",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811445",
            "telephone_number": "781-431-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456002",
            "telephone_number": "857-307-0896",
            "fax_number": "617-525-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGUEN",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "153621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179426",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.