Individual provider Active NPI

Edward M. Kowaloff, M.D.

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1437147071
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44238 Issued in MA
Practice address
725 Concord Ave
Suite 4100
Cambridge, MA 02138-1040
Phone
(617) 864-8822
Fax
(617) 547-5367
NPI assigned
Oct 7, 2005
Last updated
Dec 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44238 MA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 44238 MA

Addresses

Primary practice location

725 Concord Ave
Suite 4100
Cambridge, MA 02138-1040

Mailing address

319 Cabot St
Newtonville, MA 02460-2255
Phone (617) 527-7501

Other identifiers 1

IdentifierTypeStateIssuer
2071614MedicaidMA

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
I20050819000144 MA Practitioner - Internal MedicinePractitioner - Endocrinology 9830129840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Washington University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Practice addresses (Care Compare)

57 Bedford St
Suite 130
Lexington, MA 02420-4543
Phone (781) 862-7500

725 Concord Ave
Suite 6100
Cambridge, MA 02138-1040
Phone (617) 864-8822

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Auburn Professional Services Inc Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients

Locations

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • Direct secure messaging: ekowaloff253966@direct.bilh.masshiway.net

Organizations & group practices 1

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 3

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1437147071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 CABOT ST",
            "city": "NEWTONVILLE",
            "state": "MA",
            "postal_code": "024602255",
            "telephone_number": "617-527-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "SUITE 4100",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-864-8822",
            "fax_number": "617-547-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALOFF",
        "first_name": "EDWARD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "44238",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "44238",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2071614",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.