NPIMap

Organization Active NPI

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

Doing business as OB/GYN - HMFP at BIDMC

  • Obstetrics & Gynecology Physician
  • Boston, MA
National Provider Identifier
1518908136
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
Doing business as
OB/GYN - HMFP at BIDMC
Practice address
330 Brookline Ave
Boston, MA 02215
Phone
(617) 632-7441
Fax
(617) 667-5011
NPI assigned
Jun 8, 2006
Last updated
Jun 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Dr. Alexandra Boer Kimball, MDNPI 1073503603
Title
Chief Executive Officer
Phone
(617) 632-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215

Mailing address

375 Longwood Ave Ste 3
Boston, MA 02215-5395
Phone (617) 632-7441

Other names 1

  • OB/GYN - HMFP at BIDMC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031204000710 MA Part B Supplier - Clinic/Group Practice 4486567104 Receives reassigned benefits from 168 practitioners
Practice locations: Winchester, MA; Weymouth, MA; Plymouth, MA; Newburyport, MA; Lexington, MA; Chestnut Hill, MA; Cambridge, MA; Brockton, MA…
O20120920000141 MA Part B Supplier - Clinic/Group Practice 4486567104 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrence, MA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

330 Brookline Ave
#205
Boston, MA 02215

330 Brookline Ave
#208
Boston, MA 02215

330 Brookline Ave
#306
Boston, MA 02215
Phone (617) 667-2932

330 Brookline Ave
#322
Boston, MA 02215
Phone (617) 667-1862

330 Brookline Ave
#330
Boston, MA 02215
Phone (617) 667-4040

330 Brookline Ave
#338
Boston, MA 02215
Phone (617) 667-7110

330 Brookline Ave
#7
Boston, MA 02215
Phone (617) 632-7483

330 Brookline Ave
#754
Boston, MA 02215

885 Washington St
Boston, MA 02111
Phone (617) 482-7555

114 North Beacon St
#116
Brighton, MA 02135
Phone (617) 783-5200

1 Brookline Pl
Ste 525
Brookline, MA 02445
Phone (617) 735-8686

330 Mount Auburn St
#3
Cambridge, MA 02138
Phone (617) 497-9646

61 Lincoln St
Ste 310
Framingham, MA 01702
Phone (508) 872-0306

1 Forbes Rd
Lexington, MA 02421
Phone (781) 674-1200

392 Chestnut St
Fl 2
Needham, MA 02492
Phone (617) 754-1800

22 Atwood Dr
#3
Northampton, MA 01060

118 Long Pond Rd
Ste 200
Plymouth, MA 02360
Phone (508) 830-2282

301 Paramount Dr
Raynham, MA 02767

90 Libbey Industrial Pkwy
#105
Weymouth, MA 02189

Practitioners & affiliated clinicians

Practitioners 224

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 224

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1518908136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LONGWOOD AVE STE 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155395",
            "telephone_number": "617-632-7441",
            "fax_number": "617-632-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-632-7441",
            "fax_number": "617-667-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "BOER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-632-7441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OB/GYN - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OB/GYN - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.