Individual provider Active NPI

Tamara Aghamolla Sussman, M.D.

  • Hematology & Oncology Physician
  • Boston, MA
National Provider Identifier
1427445097
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35.134308 Issued in OH
Practice address
450 Brookline Ave
Boston, MA 02215-5450
Phone
(617) 632-5055
Fax
(617) 632-6727
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 57026465 OH
Medical Oncology Physician 207RX0202X 287462 MA
Medical Oncology Physician 207RX0202X 35.134308 OH
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 35.134308 OH Primary

Addresses

Primary practice location

450 Brookline Ave
Boston, MA 02215-5450

Mailing address

450 Brookline Ave
Boston, MA 02215-5450
Phone (617) 632-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210814000113 MA Practitioner - Medical Oncology 4688938541 Reassigns benefits to 1 organization
I20230809002873 OH Practitioner - Hematology/Oncology 4688938541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57026465OHMDInternal Medicine Physician
287462MAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation Single Specialty CurrentSince Jul 26, 2023 Accepting new patients
Dana-Farber Cancer Institute, Inc. Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Single Specialty Past Accepting new patients

Locations

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

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

26900 Cedar Rd
Cleveland, OH 44122
Phone (216) 839-3000

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1427445097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-5055",
            "fax_number": "617-632-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-5055",
            "fax_number": "617-632-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "TAMARA",
        "middle_name": "AGHAMOLLA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57026465",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MA",
            "license": "287462",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OH",
            "license": "35.134308",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35.134308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.