Individual provider Active NPI

Angelos Sourpis, M.D.

  • Psychiatry Physician
  • Chestnut Hill, MA
National Provider Identifier
1780912790
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
242877 Issued in MA
Practice address
300 South St
Chestnut Hill, MA 02467-3658
Phone
(617) 469-0300
NPI assigned
Dec 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 242877 MA Primary

Addresses

Primary practice location

300 South St
Chestnut Hill, MA 02467-3658

Mailing address

300 South St
Chestnut Hill, MA 02467-3658
Phone (617) 469-0300

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
I20101222000727 MA Practitioner - Psychiatry 4385832013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Psychiatric Planners, IncGroup PAC ID 3476653387, 11 clinicians

Practice addresses (Care Compare)

300 S St
Chestnut Hill, MA 02467-3658
Phone (617) 469-0300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Psychiatric Planners, Inc CurrentSince Dec 1, 2014 Accepting new patients

Locations

300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1780912790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTH ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673658",
            "telephone_number": "617-469-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SOUTH ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673658",
            "telephone_number": "617-469-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURPIS",
        "first_name": "ANGELOS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-02",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "242877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.