Individual provider Active NPI

Didier Cros, MD

  • Neurology Physician
  • Boston, MA
National Provider Identifier
1477575413
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
P58685 Issued in MA
Practice address
1 Hawthorne Place
Suite 105
Boston, MA 02114
Phone
(617) 720-0030
Fax
(617) 720-0055
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 58685 MA
Neurology Physician 2084N0400X P58685 MA Primary

Addresses

Primary practice location

1 Hawthorne Place
Suite 105
Boston, MA 02114

Mailing address

1 Hawthorne Place
Suite 105
Boston, MA 02114
Phone (617) 720-0030

Other identifiers 4

IdentifierTypeStateIssuer
M19362OtherBLUE CROSS
J10191OtherMABCBS MA
724855OtherMATUFTS HEALTH PLAN
3069257MedicaidMA

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
I20050412000058 MA Practitioner - Neurology 4284671264 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58685MAMDNeurology Physician
P58685MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Didier Cros MD PC Neurology CurrentSince Dec 13, 2015 Accepting new patients

Locations

1 Hawthorne Pl
Ste 105
Boston, MA 02114
Phone (617) 726-1344

3 Hawthorne Pl
Ste 112
Boston, MA 02114
Phone (617) 720-0030

Interoperability endpoints

  • Direct secure messaging: cros.didier.mgh@direct.partners.masshiway.net
  • Direct secure messaging: dcros253166@direct.bilh.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1477575413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HAWTHORNE PLACE",
            "address_2": "SUITE 105",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-720-0030",
            "fax_number": "617-720-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAWTHORNE PLACE",
            "address_2": "SUITE 105",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-720-0030",
            "fax_number": "617-720-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROS",
        "first_name": "DIDIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "58685",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "P58685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M19362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J10191",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "724855",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069257",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.