NPIMap

Individual provider Active NPI

McKinley Glover IV, M.D., M.H.S.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1457650079
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
255258 Issued in MA
Practice address
55 Fruit St
FND 216
Boston, MA 02114-2621
Phone
(617) 724-4255
NPI assigned
Mar 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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 BP10040628 TX
Diagnostic Radiology Physician 2085R0202X 255258 MA Primary

Addresses

Primary practice location

55 Fruit St
FND 216
Boston, MA 02114-2621

Mailing address

55 Fruit St
FND 216
Boston, MA 02114-2621
Phone (617) 724-4255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160324001619 MA Practitioner - Diagnostic Radiology 2264684299 Reassigns benefits to 3 organizations
Practice locations: Framingham, MA
I20210204001018 DC Practitioner - Diagnostic Radiology 2264684299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Duke University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Radiologists IncGroup PAC ID 2466355383, 92 clinicians

Practice addresses (Care Compare)

Washington, DC 20012-1116
Phone (252) 752-5000

151 Everett Ave
Chelsea, MA 02150-1812
Phone (617) 884-8300

335 Revolution Dr
Somerville, MA 02145-1553
Phone (857) 282-7750

3586 Sharpes Meadow LN
Fairfax, VA 22030-3239
Phone (252) 752-5000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10040628TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Urgent Care LLC CurrentSince May 1, 2020 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2016 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince May 1, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

55 Fruit St
#216
Boston, MA 02114
Phone (617) 724-4255

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

Interoperability endpoints

  • Direct secure messaging: glover.mckinley.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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 6

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1457650079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "FND 216",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "FND 216",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "MCKINLEY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D., M.H.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10040628",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "255258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.