Individual provider Active NPI

Hilde Vardeh, M.D.

  • Clinical Pathology Physician
  • Boston, MA
National Provider Identifier
1578937587
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
MD16658 Issued in RI
Practice address
300 Brookline Ave
Department of Pathology
Boston, MA 02215-5403
Phone
(617) 667-4344
Fax
(617) 667-7120
NPI assigned
Nov 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 256158 MA
Clinical Pathology Physician 207ZC0006X MD16658 RI Primary

Addresses

Primary practice location

300 Brookline Ave
Department of Pathology
Boston, MA 02215-5403

Mailing address

300 Brookline Ave
Department of Pathology
Boston, MA 02215-5403
Phone (617) 667-4344

Other practice location 1

33 Staniford St Fl 2
Providence, RI 02905-3105
Phone (401) 421-8800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190813001121 MA Practitioner - Pathology 7416283049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Pathology Associates IncGroup PAC ID 7517938962, 4 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3355

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256158MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Metrowest Pathology Associates CurrentSince Aug 1, 2019 Accepting new patients
Emerson Pathology Associates, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Gbgastro LLC CurrentSince Nov 1, 2019 Accepting new patients

Locations

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

475 Franklin St
Ste 110
Framingham, MA 01702
Phone (508) 620-9200

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1578937587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BROOKLINE AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155403",
            "telephone_number": "617-667-4344",
            "fax_number": "617-667-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BROOKLINE AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155403",
            "telephone_number": "617-667-4344",
            "fax_number": "617-667-7120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Staniford St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053105",
            "country_code": "US",
            "telephone_number": "401-421-8800",
            "fax_number": "401-421-2492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARDEH",
        "first_name": "HILDE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "256158",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "RI",
            "license": "MD16658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.