NPIMap

Organization Active NPI

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc

Doing business as Podiatry/Surgery - HMFP at BIDMC

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1649210907
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC
Doing business as
Podiatry/Surgery - HMFP at BIDMC
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 632-7390
NPI assigned
Jun 7, 2006
Last updated
Sep 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Alexandra Boer Kimball, MDNPI 1073503603
Title
Ceo and President
Phone
(617) 632-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

375 Longwood Ave Ste 3B
Boston, MA 02215-5395
Phone (617) 632-7441

Other identifiers 1

IdentifierTypeStateIssuer
9768238MedicaidMA

Other names 1

  • Podiatry/Surgery - HMFP at BIDMC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Harvard Medical Faculty Physicians29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1649210907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LONGWOOD AVE STE 3B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155395",
            "telephone_number": "617-632-7441",
            "fax_number": "617-632-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-632-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "BOER",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "617-632-7441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9768238",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Podiatry/Surgery - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Podiatry/Surgery - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.