NPIMap

Individual provider Active NPI

Nicole Marie Dubosh, M.D.

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1467747576
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
248821 Issued in MA
Practice address
1 Deaconess Rd
W-CC2
Boston, MA 02215-5321
Phone
(313) 617-7191
NPI assigned
Jun 16, 2011
Last updated
Jun 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 248821 MA Primary

Addresses

Primary practice location

1 Deaconess Rd
W-CC2
Boston, MA 02215-5321

Mailing address

1477 Beacon St
Apt 34
Brookline, MA 02446-4738
Phone (313) 617-7191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010000215 MA Practitioner - Emergency Medicine 4587884739 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

100 Walter J Hannon Pkwy
Suite 143
Quincy, MA 02169-1105
Phone (617) 615-4000

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-5398

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248821MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 4, 2014 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 4, 2014 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2014 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2014 Accepting new patients

Locations

1 Deaconess Rd
#2
Boston, MA 02215
Phone (617) 754-2323

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

910 Washington St
Dedham, MA 02026
Phone (781) 431-1333

100 Highland St
Milton, MA 02186
Phone (617) 615-4000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 Walter J Hannon Pkwy
Ste 143
Quincy, MA 02169
Phone (617) 615-4000

Interoperability endpoints

  • Direct secure messaging: ndubosh252950@direct.bilh.masshiway.net

Organizations & group practices 10

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 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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1467747576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 BEACON ST",
            "address_2": "APT 34",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464738",
            "telephone_number": "313-617-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "W-CC2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "313-617-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSH",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "248821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.