Suprav Mishra, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

252898 Issued in MA

Practice address

2100 Dorchester Ave
Dorchester, MA 02124-5615

Phone

(617) 296-4000

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Rohit Rattan MD PLLCGroup PAC ID 5294105144, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tides Hospice, LLC Hospice, Norwell, MA, CCN 221622
• West River Hospice Hospice, Needham, MA, CCN 221604
• Beacon Hospice, an Amedisys Company Hospice, Charlestown, MA, CCN 221544
• Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111
• Copley at Stoughton Nursing Care Center Nursing home, Stoughton, MA, CCN 225653
• Champion Rehabilitation and Nursing Center Nursing home, Brockton, MA, CCN 225221

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smishra257524@direct.bmc.masshiway.net

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.

• BMC Affiliated Physicians, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1245320910
  Medicare reassignment Care Compare group NPD
• Rohit Rattan MD PLLC

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1780396937
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Massachusetts II PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1306376397
  Medicare reassignment NPD
• Sound Physicians of Massachusetts Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1740678408
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Sound Physicians of Massachusetts, Inc

  • Internal Medicine Physician
  • Holyoke, MA
  • NPI 1184178386
  NPD
• Sound Physicians of Massachusetts, Inc

  • Internal Medicine Physician
  • Stoughton, MA
  • NPI 1245784446
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Boston Medical Center - South Corporation

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  NPD (past)
• Brockton Rehabilitation and Nursing Center LLC

  • Skilled Nursing Facility
  • Brockton, MA
  • NPI 1306511852
  NPD (past)
• Copley Health Care Partnership

  • Skilled Nursing Facility
  • Stoughton, MA
  • NPI 1508853177
  NPD (past)
• Steward Carney Hospital, Inc.

  • General Acute Care Hospital
  • Dorchester Center, MA
  • NPI 1427360981
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beacon Hospice, LLC

  • Community Based Hospice Care Agency
  • Fall River, MA
  • NPI 1932283694
  Care Compare affiliation Name & address match
• Boston Medical Center - South Corporation

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  Care Compare affiliation
• Brockton Rehabilitation and Nursing Center LLC

  • Skilled Nursing Facility
  • Brockton, MA
  • NPI 1306511852

  Nursing home

  Care Compare affiliation
• Copley Health Care Partnership

  • Skilled Nursing Facility
  • Stoughton, MA
  • NPI 1508853177

  Nursing home

  Care Compare affiliation
• Tides Hospice LLC

  • Community Based Hospice Care Agency
  • Norwell, MA
  • NPI 1538909353
  Care Compare affiliation
• West River Hospice LLC

  • Community Based Hospice Care Agency
  • Needham, MA
  • NPI 1336675263
  Care Compare affiliation

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1497010748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "SUPRAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "257914",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "252898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milton Acupuncture
• Mindwell Meds
• Julita Mir, MD
• Teresa Mirabito, NP
• Frances Miranda, PHARMD
• Christopher John Mistretta, FNP-BC
• Andrea Mitchell
• Fuchsia Y Mitchell, M.D.
• Katrina Mitchell, MA
• Geoffrey Alan Modest, MD

• Internal Medicine Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.