Individual provider Active NPI

Rebecca Tyler Brown, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Roslindale, MA
National Provider Identifier
1689701674
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
235503 Issued in MA
Practice address
1200 Centre St
Department of Medicine
Roslindale, MA 02131-1011
Phone
(617) 363-8710
Fax
(617) 363-8929
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 235503 MA Primary
Internal Medicine Physician 207R00000X 235503 MA

Addresses

Primary practice location

1200 Centre St
Department of Medicine
Roslindale, MA 02131-1011

Mailing address

1200 Centre St
Department of Medicine
Roslindale, MA 02131-1011
Phone (617) 363-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231003000635 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3476693433

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98036CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1689701674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CENTRE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311011",
            "telephone_number": "617-363-8710",
            "fax_number": "617-363-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CENTRE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311011",
            "telephone_number": "617-363-8710",
            "fax_number": "617-363-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REBECCA",
        "middle_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "235503",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "235503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.