NPIMap

Organization Active NPI

Bosley Medical Group, P.C.

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1710322854
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BOSLEY MEDICAL GROUP, P.C.
Practice address
545 Boylston St
Penthouse
Boston, MA 02116-3606
Phone
(617) 375-9600
NPI assigned
May 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Dr. Kenneth J. Washenik, M.D., PH.D.NPI 1487797940
Title
President
Phone
(310) 288-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

545 Boylston St
Penthouse
Boston, MA 02116-3606

Mailing address

9100 Wilshire Blvd
East Tower Penthouse
Beverly Hills, CA 90212-3415
Phone (310) 288-4410

National Provider Directory

National Provider Directory

Locations

9100 Wilshire Blvd
Ph East
Beverly Hills, CA 90212
Phone (310) 288-9999

545 Boylston St
Ph
Boston, MA 02116
Phone (617) 375-9600

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1710322854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WILSHIRE BLVD",
            "address_2": "EAST TOWER PENTHOUSE",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123415",
            "telephone_number": "310-288-4410",
            "fax_number": "310-734-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BOYLSTON ST",
            "address_2": "PENTHOUSE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163606",
            "telephone_number": "617-375-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSLEY MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "WASHENIK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-288-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "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 May 2, 2013; 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.