Active NPI
Suzanne F Roland, MD
- Neuroradiology Physician
- Boston, MA
National Provider Identifier
1770540486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- 79576
- Practice address
- 133 Brookline Ave
Boston, MA 02215-3904 - Phone
- (617) 421-1000
- Fax
- (617) 421-1000
- NPI assigned
- Apr 27, 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 |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | 79576 | MA | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 79576 | MA |
Addresses
Primary practice location
133 Brookline Ave
Boston, MA 02215-3904
Mailing address
147 Milk St
Provider Enrollment Department - 9TH Floor
Boston, MA 02109-4806
Phone (617) 421-2508
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AA6734 | Other | MD | HARVARD PILGRIM |
| 0802501 | Other | MA | HEALTHSOURCE |
| 0031939 | Other | MD | NEIGHBORHOOD HEALTH |
| 079576 | Other | MD | TUFTS HEALTH PLAN |
| J30581 | Other | MD | B;IE CROSS BLUE SHIELD |
| 0802501 | Other | MA | CIGNA |
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 |
|---|---|---|---|
| 79551 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Touchstone Imaging of Denver LLC | Past | Accepting new patients | |
| Dry Creek Imaging LLC | Diagnostic Radiology | Past | Accepting new patients |
| Radiology Specialists of Denver-PC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Radiology Clinic/Center
- Denver, CO
- NPI 1487687190
-
- Radiology Clinic/Center
- Littleton, CO
- NPI 1790721801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1770540486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT DEPARTMENT - 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-421-2508",
"fax_number": "617-421-3487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022153904",
"telephone_number": "617-421-1000",
"fax_number": "617-421-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLAND",
"first_name": "SUZANNE",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "MA",
"license": "79576",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "79576",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "AA6734",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "0802501",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0031939",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "079576",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B;IE CROSS BLUE SHIELD",
"identifier": "J30581",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0802501",
"state": "MA"
}
],
"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 Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.