Individual provider Active NPI

Arkady S Fishman, MEDICAL DOCTOR

  • Internal Medicine Physician
  • Brookline, MA
National Provider Identifier
1497872709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50408 Issued in MA
Practice address
1180 Beacon Street
Room 6a
Brookline, MA 02135
Phone
(617) 731-6110
Fax
(617) 731-8466
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50408 MA Primary

Addresses

Primary practice location

1180 Beacon Street
Room 6a
Brookline, MA 02135

Mailing address

300 Allston Street
#307
Brighton, MA 02135
Phone (617) 731-6110

Other identifiers 1

IdentifierTypeStateIssuer
3003833MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50408MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boris Balson, PC PastSince Dec 2, 2015 Accepting new patients
Measured Wellness LLC PastSince Oct 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497872709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ALLSTON STREET",
            "address_2": "#307",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-731-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON STREET",
            "address_2": "ROOM 6A",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-731-6110",
            "fax_number": "617-731-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "ARKADY",
        "middle_name": "S",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "50408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003833",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.