Individual provider Active NPI

Ferne R. Braveman, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1497738355
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
55545 Issued in MA
Practice address
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone
(617) 638-6950
Fax
(617) 638-6966
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 55545 MA Primary
Anesthesiology Physician 207L00000X 028763 CT
Anesthesiology Physician 207L00000X G151372 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X 028763 CT

Addresses

Primary practice location

1 Boston Medical Ctr PL
Boston, MA 02118-2908

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-0309

Other practice location 1

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 273-3000

Other identifiers 1

IdentifierTypeStateIssuer
001287631MedicaidCT

Other names 1

  • Ferne B. Servarino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171116000134 CA Practitioner - Anesthesiology 0143205518 Reassigns benefits to 1 organization
I20201228000380 MN Practitioner - Anesthesiology 0143205518 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G151372CAMDAnesthesiology Physician
028763CTMDAnesthesiology Physician
55545MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Anesthesiology CurrentSince Nov 1, 2017 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Nov 1, 2017 Accepting new patients
University Anesthesia Providers, LLC Anesthesiology CurrentSince Nov 23, 2020 Accepting new patients

Locations

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

Organizations & group practices 3

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1497738355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021180309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-638-6950",
            "fax_number": "617-638-6966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Harvard St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550363",
            "country_code": "US",
            "telephone_number": "612-273-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVEMAN",
        "first_name": "FERNE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "55545",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "028763",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G151372",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CT",
            "license": "028763",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001287631",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNE",
            "last_name": "SERVARINO",
            "middle_name": "B.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.