Individual provider Active NPI

Elsie Levin, MD

  • Diagnostic Radiology Physician
  • Wellesley Hills, MA
National Provider Identifier
1447236161
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
72761 Issued in MA
Practice address
165 Worcester St
Wellesley Hills, MA 02481-3615
Phone
(617) 553-5300
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 72761 MA Primary

Addresses

Primary practice location

165 Worcester St
Wellesley Hills, MA 02481-3615

Mailing address

PO Box 9135
Brookline, MA 02446-9135
Phone (603) 893-9784

Other identifiers 3

IdentifierTypeStateIssuer
735972OtherMATUFTS
J09976OtherMABLUE CROSS BLUE SHIELD
3066002MedicaidMA

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
I20050411001143 MA Practitioner - Diagnostic Radiology 4082651138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breast Imaging Physicians PCGroup PAC ID 5698815355, 3 clinicians

Practice addresses (Care Compare)

165 Worcester St
Wellesley, MA 02481-3615
Phone (617) 553-5300

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72761MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breast Imaging Physicians PC Diagnostic Radiology CurrentSince Jun 6, 1990 Accepting new patients
Boston Breast Diagnostic Center LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

165 Worcester St
Wellesley Hls, MA 02481
Phone (617) 553-5300

9 Northeastern Blvd
Ste 400
Salem, NH 03079

Organizations & group practices 2

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 1

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1447236161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9135",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024469135",
            "telephone_number": "603-893-9784",
            "fax_number": "603-893-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WORCESTER ST",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024813615",
            "telephone_number": "617-553-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "ELSIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "72761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "735972",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J09976",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3066002",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.