NPIMap

Individual provider Active NPI

Jeffrey J. Siracuse, M.D.

  • Vascular Surgery Physician
  • Boston, MA
National Provider Identifier
1780874875
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
233724 Issued in MA
Practice address
732 Harrison Ave
Preston, 3Rd. Floor
Boston, MA 02118-2309
Phone
(617) 638-8488
Fax
(617) 638-8469
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 233724 MA
Vascular Surgery Physician 2086S0129X 233724 MA Primary

Addresses

Primary practice location

732 Harrison Ave
Preston, 3Rd. Floor
Boston, MA 02118-2309

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627001098 MA Practitioner - Vascular SurgeryPractitioner - General Surgery 9234354689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University General Surgical Associates, Inc.Group PAC ID 9830183763, 86 clinicians
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8605

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

732 Harrison Ave
Boston, MA 02118-2309

732 Harrison Ave FL 3
Preston BLDG
Boston, MA 02118-2309
Phone (617) 638-7350

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)16
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Jul 1, 2014 Accepting new patients
Boston University General Surgical Associates, Inc. Surgery CurrentSince Jul 1, 2014 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

720 Harrison Ave
Ste 700
Boston, MA 02118
Phone (617) 638-8488

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: jsiracuse72455@direct.bmc.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1780874875",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 HARRISON AVE",
            "address_2": "PRESTON, 3RD. FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182309",
            "telephone_number": "617-638-8488",
            "fax_number": "617-638-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSE",
        "first_name": "JEFFREY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "233724",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "233724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.