Active NPI
Deborah Levine, MD
- Diagnostic Radiology Physician
- Boston, MA
National Provider Identifier
1760423966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 79542
- Practice address
- 330 Brookline Ave
Beth Israel Deaconess Medical Center
Boston, MA 02215-5491 - Phone
- (617) 667-8901
- Fax
- (617) 667-8212
- NPI assigned
- Jun 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 79542 | MA | Primary |
| Diagnostic Radiology Physician | 2085R0202X | G66972 | CA |
Addresses
Primary practice location
330 Brookline Ave
Beth Israel Deaconess Medical Center
Boston, MA 02215-5491
Mailing address
147 Sherburn Cir
Weston, MA 02493-1049
Phone (781) 235-1697
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3128474 | Medicaid | MA | |
| B20271101 | Other | MA | CIGAN/HEALTHSOURCE HMO1 |
| 300111897 | Other | MA | RAILROAD MEDICARE |
| 4509267 | Other | MA | AETNA NONHMO |
| 16-00623 | Other | MA | UNITED DIRECT ACCESS2 |
| 0487897 | Other | MA | AETNA HMO1 |
| 3580927-001 | Other | MA | DIGNA PAL 1 |
| 70010000J30678 | Other | MD | BLUE CROSS |
| 079542 | Other | MA | SECURE HORIZONS, TUFTS |
| F64452BI | Other | MA | HARVARD PILGRIM |
| 2186722 | Other | MA | AETNA HMO2 |
| 39754 | Other | MA | FALLON |
| 16-01485 | Other | MA | EVERCARE |
| 989793 | Other | MA | NETWORK HEALTH |
| 16-40213 | Other | MA | UNITED DIRECT ACCESS 1 |
Other names 1
- Deborah L Jesurum
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G66972 | CA | MD | Diagnostic Radiology Physician |
| 79542 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1760423966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 SHERBURN CIR",
"city": "WESTON",
"state": "MA",
"postal_code": "024931049",
"telephone_number": "781-235-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155491",
"telephone_number": "617-667-8901",
"fax_number": "617-667-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "DEBORAH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "79542",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G66972",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3128474",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGAN/HEALTHSOURCE HMO1",
"identifier": "B20271101",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300111897",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NONHMO",
"identifier": "4509267",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED DIRECT ACCESS2",
"identifier": "16-00623",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO1",
"identifier": "0487897",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIGNA PAL 1",
"identifier": "3580927-001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "70010000J30678",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURE HORIZONS, TUFTS",
"identifier": "079542",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "F64452BI",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO2",
"identifier": "2186722",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "39754",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "16-01485",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "989793",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED DIRECT ACCESS 1",
"identifier": "16-40213",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "JESURUM",
"middle_name": "L",
"credential": "MD",
"code": "5",
"type": "Other 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 Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.