Individual provider Active NPI

Bilawal Nadeem, M.D.

  • Internal Medicine Physician
  • Brighton, MA
National Provider Identifier
1730875568
Registry record updated May 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3014713 Issued in MA
Practice address
St. Elizabeth's Medical Center
736 Cambridge Street
Brighton, MA 02135
Phone
(617) 789-3000
NPI assigned
Apr 14, 2023
Reactivated
Dec 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2024

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 3014713 MA Primary

Addresses

Primary practice location

St. Elizabeth's Medical Center
736 Cambridge Street
Brighton, MA 02135

Mailing address

11 Nevins St Ste 308
Brighton, MA 02135-3514
Phone (617) 789-3000

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
I20240618001196 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8628511748

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3014713MAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: bnadeem251847@direct.bmc.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1730875568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NEVINS ST STE 308",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353514",
            "telephone_number": "617-789-3000",
            "fax_number": "815-205-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. ELIZABETH'S MEDICAL CENTER",
            "address_2": "736 CAMBRIDGE STREET",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-789-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEEM",
        "first_name": "BILAWAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-14",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "deactivation_date": "2023-11-17",
        "reactivation_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "3014713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.