Individual provider Active NPI

Eugene L Vaninov, MD

  • Specialist
  • Brighton, MA
National Provider Identifier
1467425280
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
76335 Issued in MA
Practice address
280 Washington St
Suite 208
Brighton, MA 02135-3511
Phone
(617) 562-1433
Fax
(617) 562-8233
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 76335 MA Primary

Addresses

Primary practice location

280 Washington St
Suite 208
Brighton, MA 02135-3511

Mailing address

280 Washington St
Suite 208
Brighton, MA 02135-3511
Phone (617) 562-1433

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
I20100916000571 MA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0042335895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

280 Washington St
208 Revere Medical Brighton Primary Care
Brighton, MA 02135-3584
Phone (617) 779-7237

Hospital & facility affiliations

  • At Home Senior Care, Inc Home health agency, Newton, MA, CCN 227536
  • Central Home Health Care, Inc Home health agency, Needham, MA, CCN 227532
  • Suburban Home Health Care, Inc Home health agency, Boston, MA, CCN 227290
  • Boston Medical Center-Brighton Hospital, Brighton, MA, CCN 220036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Specialist CurrentSince Nov 19, 2012 Accepting new patients
Revere Medical of Massachusetts, PC CurrentSince Dec 21, 2024 Accepting new patients
Steward Medical Group, Inc Specialist CurrentSince Nov 19, 2012 Accepting new patients

Locations

280 Washington St
Ste 208
Brighton, MA 02135
Phone (617) 562-1433

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

62 Brown St
#507
Haverhill, MA 01830
Phone (978) 722-7818

Interoperability endpoints

  • Direct secure messaging: eugene.vaninov.1@32866.direct.athenahealth.com

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 and National Provider Directory roles.

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1467425280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 WASHINGTON ST",
            "address_2": "SUITE 208",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353511",
            "telephone_number": "617-562-1433",
            "fax_number": "617-562-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 WASHINGTON ST",
            "address_2": "SUITE 208",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353511",
            "telephone_number": "617-562-1433",
            "fax_number": "617-562-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANINOV",
        "first_name": "EUGENE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "76335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.