Boston Advanced Medicine Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

BOSTON ADVANCED MEDICINE INC

Practice address

281 Winter St FL 2
Waltham, MA 02451-8740

Phone

(781) 895-7900

NPI assigned

Jan 24, 2007

Last updated

Apr 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erin Kotwicki

Title

Practice Administrator

Phone

(781) 895-7903

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Tax ID family

Boston Advanced Medicine in3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Boston Advanced Medicine Inc

  • Clinical Medical Laboratory
  • Waltham, MA
  • NPI 1255867487
  NPD tax ID
• Boston Advanced Medicine Inc

  • Pain Medicine Physician
  • Waltham, MA
  • NPI 1558791475
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carlos F Bazoberry, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Waltham, MA
  • NPI 1013963271
  Medicare reassignment Care Compare group NPD
• David J Dibenedetto, M.D.

  • Interventional Pain Medicine Physician
  • Waltham, MA
  • NPI 1770599029
  Medicare reassignment Care Compare group NPD
• Susan Michele Lim, M.D.

  • Anesthesiology Physician
  • Boston, MA
  • NPI 1205194792
  Medicare reassignment Care Compare group NPD
• Lee Scott Silk, M.D.

  • Interventional Pain Medicine Physician
  • Waltham, MA
  • NPI 1487693479
  Medicare reassignment Care Compare group NPD
• Victor Wang

  • Anesthesiology Physician
  • Boston, MA
  • NPI 1518225952
  Medicare reassignment Care Compare group NPD
• Douglas F Keene, M.D.

  • Anesthesiology Physician
  • Waltham, MA
  • NPI 1598811234

  Pain Medicine

  Medicare reassignment NPD
• Michael Gerald Kennedy, MD

  • Orthopaedic Trauma Physician
  • Natick, MA
  • NPI 1295767614
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1427103258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 WINTER ST FL 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518740",
            "telephone_number": "781-895-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 WINTER ST FL 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518740",
            "telephone_number": "781-895-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON ADVANCED MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "KOTWICKI",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "781-895-7903"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Bornfriend, DMD
• Marina Borocov, NP
• Elizabeth Bosco, LCSW
• Boston Advanced Anesthesia, Inc (Greater Boston Anesthesia Associates)
• Boston Advanced Medicine Inc
• Boston Advanced Medicine Inc
• Boston Brace International Inc. (OP Specialty Bracing)
• Boston Brace International Inc. (OP Specialty Bracing)
• Boston Clinical Laboratories, Inc
• Boston Eye Surgery & Laser Center Trust (Boston Eye Surgery & Laser Center)

• Pain Medicine Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Pain Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.