Individual provider Active NPI

Serene Samir Srouji, MD

  • Reproductive Endocrinology Physician
  • Boston, MA
National Provider Identifier
1639150394
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
217592 Issued in MA
Practice address
Department of Obstetrics and Gynecology
75 Francis Street Asb1
Boston, MA 02115
Phone
(617) 732-4648
Fax
(617) 975-0870
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 217592 MA Primary

Addresses

Primary practice location

Department of Obstetrics and Gynecology
75 Francis Street Asb1
Boston, MA 02115

Mailing address

Department of Obstetrics and Gynecology
75 Francis Street Asb1
Boston, MA 02115
Phone (617) 732-4648

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
I20070111000163 MA Practitioner - Obstetrics/Gynecology 5496755704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Johns Hopkins University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217592MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Reproductive Endocrinology CurrentSince Jan 1, 2011 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Ozarks Medical Center Past Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

Bwpo
Dept Of Ivf Globals
Boston, MA 02241

75 Francis St
Boston, MA 02115

75 Francis St
#1
Boston, MA 02115
Phone (617) 732-6310

Interoperability endpoints

  • Direct secure messaging: srouji.serene.bwh@direct.partners.masshiway.net

Organizations & group practices 5

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 1

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1639150394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF OBSTETRICS AND GYNECOLOGY",
            "address_2": "75 FRANCIS STREET ASB1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-4648",
            "fax_number": "617-975-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF OBSTETRICS AND GYNECOLOGY",
            "address_2": "75 FRANCIS STREET ASB1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-4648",
            "fax_number": "617-975-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUJI",
        "first_name": "SERENE",
        "middle_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MA",
            "license": "217592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.