NPIMap

Individual provider Active NPI

Irina Catrinel Gavanescu Stockton, M.D., PH. D.

  • Rheumatology Physician
  • Boston, MA
National Provider Identifier
1629397906
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
253962 Issued in MA
Practice address
110 Francis St
Suite 4B
Boston, MA 02215-5501
Phone
(508) 410-2578
NPI assigned
May 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 253962 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X 243781 MA
Internal Medicine Physician 207R00000X 253962 MA

Addresses

Primary practice location

110 Francis St
Suite 4B
Boston, MA 02215-5501

Mailing address

110 Francis St
Suite 4B
Boston, MA 02215-5501
Phone (508) 410-2578

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
I20131119001787 MA Practitioner - RheumatologyPractitioner - Internal Medicine 3173759255 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011
  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
  • Lemuel Shattuck Hospital Long-term care hospital, Jamaica Plain, MA, CCN 222006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253962MAMDInternal Medicine Physician
243781MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2016 Accepting new patients
Cambridge Public Health Commission CurrentSince Oct 8, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

110 Francis St
Ste 4B
Boston, MA 02215
Phone (617) 632-8658

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: igavanescu4666@direct.challiance.masshiway.net
  • Direct secure messaging: igavanescustockton254737@direct.bilh.masshiway.net

Organizations & group practices 6

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1629397906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "address_2": "SUITE 4B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "508-410-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "address_2": "SUITE 4B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "508-410-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVANESCU STOCKTON",
        "first_name": "IRINA",
        "middle_name": "CATRINEL",
        "name_prefix": "Dr.",
        "credential": "M.D., PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MA",
            "license": "253962",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "243781",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "253962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.