Individual provider Active NPI

Reda M Safieddine, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1689862534
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233912 Issued in MA
Practice address
736 Cambridge Street
Caritas Saint Elizabeth Medical Center
Boston, MA 02135
Phone
(617) 571-5915
NPI assigned
Oct 4, 2007
Last updated
Jul 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233912 MA Primary

Addresses

Primary practice location

736 Cambridge Street
Caritas Saint Elizabeth Medical Center
Boston, MA 02135

Mailing address

1515 Commonwealth Ave
Kindred Hospital Boston
Boston, MA 02135
Phone (617) 562-5359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233912MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1689862534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 COMMONWEALTH AVE",
            "address_2": "KINDRED HOSPITAL BOSTON",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-562-5359",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE STREET",
            "address_2": "CARITAS SAINT ELIZABETH MEDICAL CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-571-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFIEDDINE",
        "first_name": "REDA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 24, 2014; 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.