Individual provider Active NPI

Deanna L Corey, MD

  • Sports Medicine (Family Medicine) Physician
  • Boston, MA
National Provider Identifier
1437460680
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
261121 Issued in MA
Practice address
725 Albany St
Shapiro 4, Suite 4B
Boston, MA 02118-2526
Phone
(617) 638-5633
Fax
(617) 414-5226
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 261121 MA Primary
Family Medicine Physician 207Q00000X 261121 MA

Addresses

Primary practice location

725 Albany St
Shapiro 4, Suite 4B
Boston, MA 02118-2526

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other identifiers 1

IdentifierTypeStateIssuer
MT196644OtherPACOMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Other names 1

  • Dr. Deanna Lynn Erb Former name

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
I20141211000613 MA Practitioner - Sports Medicine 7416189766 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261121MAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medical Associates-Ebnhc CurrentSince Nov 17, 2014 Accepting new patients
Neighborhealth Corporation CurrentSince Nov 17, 2014 Accepting new patients
Emerson Practice Associates, Inc. CurrentSince Jul 18, 2018 Accepting new patients
Boston University Orthopaedic Surgical Associates, Inc. Past Accepting new patients

Locations

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1437460680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 4, SUITE 4B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-5633",
            "fax_number": "617-414-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "DEANNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MA",
            "license": "261121",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "261121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE",
            "identifier": "MT196644",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "ERB",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.