NPIMap

Individual provider Active NPI

Benjamin Michael Kozak, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1487015384
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A202269 Issued in CA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 643-3726
NPI assigned
Mar 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2025-01005 NC
Diagnostic Radiology Physician 2085R0202X 55581 KY
Diagnostic Radiology Physician 2085R0202X 277329 MA
Diagnostic Radiology Physician 2085R0202X T2656 TX
Diagnostic Radiology Physician 2085R0202X D0091889 MD
Diagnostic Radiology Physician 2085R0202X 35.146016 OH
Diagnostic Radiology Physician 2085R0202X A202269 CA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone (510) 683-9500

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250609000902 CA Practitioner - Diagnostic Radiology 5395017354 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Francisco School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Radiology Group IncGroup PAC ID 7113817149, 31 clinicians
University of KentuckyGroup PAC ID 3072425289, 778 clinicians
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians
Blue Ridge Healthcare Medical Group IncGroup PAC ID 9436159712, 222 clinicians
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Lafayette, CA 94549
Phone (903) 663-4800

3340 Johnson Rd
Lafayette, CA 94549-2132
Phone (859) 323-2374

Hospital & facility affiliations

  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Blue Ridge Healthcare Hospitals, Inc Hospital, Morganton, NC, CCN 340075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A202269CAMDDiagnostic Radiology Physician
55581KYMDDiagnostic Radiology Physician
D0091889MDMDDiagnostic Radiology Physician
2025-01005NCMDDiagnostic Radiology Physician
35.146016OHMDDiagnostic Radiology Physician
T2656TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince May 1, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jul 1, 2025 Accepting new patients
Pacific Radiology Group Inc Diagnostic Radiology CurrentSince Jul 15, 2025 Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince May 1, 2025 Accepting new patients
General Hospital Corp Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Past Accepting new patients
Rocky Hill Imaging Center, LLC Diagnostic Radiology PastSince Nov 15, 2021 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients
Sutter Valley Medical Foundation Past Accepting new patients

Locations

321 N Kuakini St
Ste 405
Honolulu, HI 96817
Phone (808) 522-0190

55 Fruit St
Boston, MA 02114

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

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

2134 14th Avenue Cir NW
Ste D
Hickory, NC 28601
Phone (828) 580-1236

10057 County Road 472
Anna, TX 75409

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

Interoperability endpoints

  • Direct secure messaging: kozak.benjamin.mgh@direct.partners.masshiway.net

Organizations & group practices 55

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.

View all 55

Hospital & facility affiliations 10

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": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1487015384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 192749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194688",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-19",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2025-01005",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "55581",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "277329",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "T2656",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0091889",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.146016",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A202269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.