Alan Stewart Penzias, M.D.

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

58565 Issued in MA

Practice address

130 2ND Ave
Boston Ivf - the Waltham Center
Waltham, MA 02451

Phone

(781) 434-6500

Fax

(781) 434-6501

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1518908136
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Boston Ivf, Inc.

  • Reproductive Endocrinology Physician
  • Waltham, MA
  • NPI 1326122839
  NPD (past)
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1043250616
  NPD (past)
• Pratt OB/GYN Associates, Inc

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1336186501
  NPD (past)
• Albany Ivf-Fertility and Gynecology Center

  • Specialist
  • Albany, NY
  • NPI 1588835763

  Reproductive Endocrinology

  NPD (past)
• Boston Ivf Fertility Services at the Women'S Hospital LLC

  • Reproductive Endocrinology Physician
  • Newburgh, IN
  • NPI 1366796252
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1497701866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 2ND AVE",
            "address_2": "BOSTON IVF - THE WALTHAM CENTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511100",
            "telephone_number": "781-434-6500",
            "fax_number": "781-434-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND AVE",
            "address_2": "BOSTON IVF - THE WALTHAM CENTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "781-434-6500",
            "fax_number": "781-434-6501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5792 Widewaters Pkwy",
            "address_purpose": "LOCATION",
            "city": "DE Witt",
            "state": "NY",
            "postal_code": "132141847",
            "country_code": "US",
            "telephone_number": "315-434-3050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Irving Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101688",
            "country_code": "US",
            "telephone_number": "518-815-2241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENZIAS",
        "first_name": "ALAN",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NY",
            "license": "272983",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "58565",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "ME",
            "license": "015833",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "RI",
            "license": "MD11056",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MA",
            "license": "58565",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "ME",
            "license": "015833",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "RI",
            "license": "MD11056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095011",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pelham Community Pharmacy, Inc
• April May Pellegrini
• Kristen Amy Pellerin
• Elena Peltola, CPS
• Yifan Peng
• Paula Pereira
• Osmerlyn Eliodoro Perez de Los Santos
• Nicole Perez Elias, LCSW
• Betsy Perez Gonzalez
• Faith Perez, LICSW

• Reproductive Endocrinology Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Reproductive Endocrinology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.