Individual provider Active NPI

Brieanne V Midura, MD

  • Pediatrics Physician
  • Norwood, MA
National Provider Identifier
1700087954
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
228531 Issued in MA
Practice address
1177 Boston Providence Tpke
Norwood, MA 02062-5019
Phone
(781) 278-5590
Fax
(781) 769-9017
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 228531 MA Primary

Addresses

Primary practice location

1177 Boston Providence Tpke
Norwood, MA 02062-5019

Mailing address

1177 Boston Providence Tpke
Norwood, MA 02062-5019
Phone (781) 278-5590

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bmiduramd20536@direct.atrius.masshiway.net

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
I20180508001899 MA Practitioner - Pediatric Medicine 5991069528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228531MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Atrius Health, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Apr 1, 2018 Accepting new patients
Atrius Health, Inc. Pediatrics PastSince Apr 1, 2018 Accepting new patients
Atrius Health, Inc. Pediatrics PastSince Feb 21, 2021 Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1700087954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 BOSTON PROVIDENCE TPKE",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625019",
            "telephone_number": "781-278-5590",
            "fax_number": "781-769-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 BOSTON PROVIDENCE TPKE",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625019",
            "telephone_number": "781-278-5590",
            "fax_number": "781-769-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDURA",
        "first_name": "BRIEANNE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "228531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmiduramd20536@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "1177 Boston Providence Tpke",
            "city": "Norwood",
            "state": "MA",
            "country_code": "US",
            "postal_code": "020625019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.