NPIMap

Individual provider Active NPI

Praveen Govender, MD

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1588811335
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
251164 Issued in MA
Practice address
725 Albany Street
Shapiro 9, Suite B
Boston, MA 02118-2526
Phone
(617) 638-7480
Fax
(617) 638-7486
NPI assigned
Aug 23, 2008
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 251164 MA
Pulmonary Disease Physician 207RP1001X 251164 MA Primary

Addresses

Primary practice location

725 Albany Street
Shapiro 9, Suite B
Boston, MA 02118-2526

Mailing address

720 Harrison Ave, Dob 5
Boston, MA 02118-4001

Other identifiers 1

IdentifierTypeStateIssuer
110092827AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000238 MA Practitioner - Pulmonary Disease 6103073200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251164MAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Pulmonary Disease CurrentSince Jul 1, 2012 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

725 Albany St
Ste B
Boston, MA 02118
Phone (617) 638-7480

720 Harrison Ave
#5
Boston, MA 02118
Phone 61741454052

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

1 Boston Medical Ctr Pl
#1
Boston, MA 02118
Phone (617) 414-4929

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: pgovender10444@direct.bmc.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1219449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1588811335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE, DOB 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY STREET",
            "address_2": "SHAPIRO 9, SUITE B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-7480",
            "fax_number": "617-638-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVENDER",
        "first_name": "PRAVEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-23",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MA",
            "license": "251164",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "251164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110092827A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.