Individual provider Active NPI

Andre Dejam, MD, PHD

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1467594259
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
233927 Issued in MA
Practice address
133 Brookline Ave
Boston, MA 02215-3904
Phone
(617) 421-6050
Fax
(617) 421-6083
NPI assigned
Feb 12, 2007
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 233927 MA Primary

Addresses

Primary practice location

133 Brookline Ave
Boston, MA 02215-3904

Mailing address

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-6050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adejammd17157@direct.atrius.masshiway.net

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
I20091223000059 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5890835854 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

1250 Hancock St
Quincy, MA 02169-4339
Phone (617) 740-0600

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

142 Berkeley St
Boston, MA 02116-5100
Phone (617) 859-5000

2 Technology Park Dr
Suite a
Bourne, MA 02532-8341
Phone (508) 743-9543

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

31 Pine St
Suite 300
Norfolk, MA 02056-1680
Phone (781) 493-7200

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

36 Shops at 5 Way
Plymouth, MA 02360-2677
Phone (774) 608-3700

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6000

77 Herrick St
Suite 101
Beverly, MA 01915-2734
Phone (978) 927-4110

90 Libbey Industrial Pkwy
Suite 201
Weymouth, MA 02189-3157
Phone (781) 682-0606

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 3, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 3, 2012 Accepting new patients
Atrius Health, Inc. Cardiovascular Disease CurrentSince Jan 5, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 3, 2012 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 3, 2012 Accepting new patients
Atrius Health, Inc. Cardiovascular Disease Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#4
Boston, MA 02215
Phone (617) 667-1282

Interoperability endpoints

  • Direct secure messaging: adejammd17157@direct.atrius.masshiway.net

Organizations & group practices 8

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 2

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1467594259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-6050",
            "fax_number": "617-421-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-6050",
            "fax_number": "617-421-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJAM",
        "first_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "233927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adejammd17157@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "133 Brookline Ave",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "022153904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.