NPIMap

Organization Active NPI

Boston University Plastic Surgery Associates, Inc.

  • Plastic Surgery Physician
  • Boston, MA
National Provider Identifier
1740228360
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
BOSTON UNIVERSITY PLASTIC SURGERY ASSOCIATES, INC.
Practice address
720 Harrison Ave
Suite 9400
Boston, MA 02118-2371
Phone
(617) 638-8419
Fax
(617) 414-8412
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
David McAneny, MDNPI 1124067129
Title
Interim President
Phone
(617) 638-8446

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
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

720 Harrison Ave
Suite 9400
Boston, MA 02118-2371

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371
Phone (617) 414-5405

Other identifiers 1

IdentifierTypeStateIssuer
110067571AMedicaidMA

Other names 1

  • Faculty Practice Foundation Boston Univ Plastic Surgery Assoc Former legal business name

National Provider Directory

National Provider Directory

Locations

720 Harrison Ave
Ste 906
Boston, MA 02118
Phone (617) 638-8419

720 Harrison Ave
Ste 9600
Boston, MA 02118
Phone (617) 638-8419

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1740228360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-414-5405",
            "fax_number": "617-414-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "SUITE 9400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-638-8419",
            "fax_number": "617-414-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON UNIVERSITY PLASTIC SURGERY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "MCANENY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "INTERIM PRESIDENT",
        "authorized_official_telephone_number": "617-638-8446",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110067571A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faculty Practice Foundation Boston Univ Plastic Surgery Assoc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 10, 2016; 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.