Individual provider Active NPI

Ivia Rivera Agosto, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Burlington, MA
National Provider Identifier
1790103299
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
274460 Issued in MA
Practice address
41 Mall Road
Burlington, MA 01805
Phone
(781) 744-8630
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 274460 MA
Internal Medicine Physician 207R00000X 260821 MA
Neurology Physician 2084N0400X 260821 MA
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 274460 MA Primary

Addresses

Primary practice location

41 Mall Road
Burlington, MA 01805

Mailing address

41 Mall Road
Burlington, MA 01805-0001
Phone (781) 744-8630

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Other practice location 2

330 Brookline Ave # Ks-406
Boston, MA 02215-5400
Phone (617) 667-2268

Other practice location 3

123 Summer St
Worcester, MA 01608
Phone (508) 363-5000

Other practice location 4

123 Summer St
Worcester, MA 01608
Phone (508) 363-5000

Other practice location 5

123 Summer St
Worcester, MA 01608
Phone (508) 363-5000

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
I20190311000219 MA Practitioner - Sleep MedicinePractitioner - Neurology 6709004526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260821MAMDInternal Medicine Physician
274460MAMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Mar 25, 2019 Accepting new patients
Lahey Clinic, Inc Internal Medicine CurrentSince Mar 25, 2019 Accepting new patients

Locations

330 Brookline Ave
#406
Boston, MA 02215
Phone (617) 667-0519

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

29 Mall Rd
Burlington, MA 01803

Interoperability endpoints

  • Direct secure messaging: iriveraagosto127111@direct.bilh.masshiway.net

Organizations & group practices 2

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 3

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1790103299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8630",
            "fax_number": "781-744-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01805",
            "telephone_number": "781-744-8630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave # Ks-406",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-2268",
            "fax_number": "617-975-5161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01608",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01608",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01608",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA AGOSTO",
        "first_name": "IVIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "274460",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "260821",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "260821",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MA",
            "license": "274460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.