NPIMap

Individual provider Active NPI

Anthony Hollenberg, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
National Provider Identifier
1699864173
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
80143 Issued in MA
Practice address
732 Harrison Ave, FL 2
Preston BLDG
Boston, MA 02118-2309
Phone
(617) 638-7470
Fax
(617) 638-7449
NPI assigned
Oct 12, 2006
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 80143 MA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 80143 MA Primary

Addresses

Primary practice location

732 Harrison Ave, FL 2
Preston BLDG
Boston, MA 02118-2309

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

Beth Israel Deaconess Medical Ctr
330 Brookline Avenue
Boston, MA 02215
Phone (617) 667-2151

Other identifiers 2

IdentifierTypeStateIssuer
110048562AMedicaidMA
3139232MedicaidNH

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
I20050407001031 MA Practitioner - EndocrinologyPractitioner - Internal Medicine 3375590615 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80143MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince Apr 27, 2009 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Apr 27, 2009 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Apr 27, 2009 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Apr 27, 2009 Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Nov 14, 2022 Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Past Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

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

732 Harrison Ave
Fl 2
Boston, MA 02118
Phone (617) 414-0040

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

960 Massachusetts Ave
Ste 2
Boston, MA 02118

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: ahollenberg177174@direct.bmc.masshiway.net
  • Direct secure messaging: thollenb@direct.nyp.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Boston Medical Center CorporationBoston, MA, CCN 220031 Hospital Corporate Officer
Corporate Director		 Apr 3, 2023
Apr 3, 2023
Boston Medical CenterBrockton, MA, CCN 22S031 Hospital Corporate Officer
Corporate Director		 Apr 3, 2023
Apr 3, 2023

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1699864173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 HARRISON AVE, FL 2",
            "address_2": "PRESTON BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182309",
            "telephone_number": "617-638-7470",
            "fax_number": "617-638-7449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Beth Israel Deaconess Medical Ctr",
            "address_2": "330 Brookline Avenue",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02215",
            "country_code": "US",
            "telephone_number": "617-667-2151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLENBERG",
        "first_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "80143",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "80143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110048562A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3139232",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.