Individual provider Active NPI

Irina A Guryanova, MD

  • Psychiatry Physician
  • Waltham, MA
National Provider Identifier
1619925898
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
202946 Issued in MA
Practice address
9 Hope Ave
Suite 500
Waltham, MA 02453-2741
Phone
(781) 647-6786
Fax
(781) 647-6753
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME 97170 FL
Psychiatry Physician 2084P0800X 202946 MA Primary

Addresses

Primary practice location

9 Hope Ave
Suite 500
Waltham, MA 02453-2741

Mailing address

10 Mohegan Rd
Acton, MA 01720-2535
Phone (978) 302-0207

Other identifiers 1

IdentifierTypeStateIssuer
202946OtherMAMA LICENSE #

Other names 1

  • Irine Guryanova Former name

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
I20130514000544 MA Practitioner - Psychiatry 7416956537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

60 Granite St
Lynn, MA 01904-2915
Phone (978) 816-2728

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 97170FLMDPsychiatry Physician
202946MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Walden Behavioral Care LLC PastSince Jul 31, 2012 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

60 Granite St
Lynn, MA 01904
Phone (781) 599-9200

Interoperability endpoints

  • Direct secure messaging: iguryanova33091@direct.bilh.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1619925898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MOHEGAN RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017202535",
            "telephone_number": "978-302-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HOPE AVE",
            "address_2": "SUITE 500",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532741",
            "telephone_number": "781-647-6786",
            "fax_number": "781-647-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURYANOVA",
        "first_name": "IRINA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 97170",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "202946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENSE #",
            "identifier": "202946",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINE",
            "last_name": "GURYANOVA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.