Individual provider Active NPI

Michael Gavin, M.D.

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1700085149
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
239198 Issued in MA
Practice address
185 Pilgrim Rd
Palmer 217
Boston, MA 02215-5324
Phone
(617) 667-8800
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 239198 MA Primary

Addresses

Primary practice location

185 Pilgrim Rd
Palmer 217
Boston, MA 02215-5324

Mailing address

185 Pilgrim Rd
Palmer 217
Boston, MA 02215-5324
Phone (617) 667-8800

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
I20111109000821 MA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9335312214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Connecticut School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

1000 Broadway
Chelsea, MA 02150-2247
Phone (781) 983-9088

148 Chestnut St
Needham, MA 02492-2505
Phone (781) 983-9088

200 Boylston St
Chestnut Hill, MA 02467-2012
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

482 Bedford St
Lexington, MA 02420-1402
Phone (781) 983-9088

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239198MAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2013 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2013 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2013 Accepting new patients

Locations

185 Pilgrim Rd
#217
Boston, MA 02215
Phone (617) 632-7941

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

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: mgavin253494@direct.bilh.masshiway.net

Organizations & group practices 4

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 4

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1700085149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD",
            "address_2": "PALMER 217",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155324",
            "telephone_number": "617-667-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD",
            "address_2": "PALMER 217",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155324",
            "telephone_number": "617-667-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "239198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.