Active NPI
Michael Reso, DO
- Diagnostic Radiology Physician
- Boston, MA
National Provider Identifier
1801539846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 3013639
- Practice address
- 800 Washington St
Boston, MA 02111-1552 - Phone
- (617) 636-0067
- NPI assigned
- Apr 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 3013639 | MA | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111-1552
Mailing address
500 J. Clyde Morris Blvd
Dept. of Medical Education/Annex: Second Floor
Newport News, VA 23601-1929
Phone (757) 594-3945
Other practice location 1
500 J. Clyde Morris Blvd
Dept. of Medical Education/Annex: Second Floor
Newport News, VA 23601-1929
Phone (757) 594-3945
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230719000729 | MA | Order and Referring Only - Diagnostic Radiology | 9638539968 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1801539846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 J. CLYDE MORRIS BLVD",
"address_2": "DEPT. OF MEDICAL EDUCATION/ANNEX: SECOND FLOOR",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236011929",
"telephone_number": "757-594-3945",
"fax_number": "757-594-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-0067"
}
],
"practiceLocations": [
{
"address_1": "500 J. Clyde Morris Blvd",
"address_2": "Dept. of Medical Education/Annex: Second Floor",
"address_purpose": "LOCATION",
"city": "Newport News",
"state": "VA",
"postal_code": "236011929",
"country_code": "US",
"telephone_number": "757-594-3945",
"fax_number": "757-594-3184",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RESO",
"first_name": "MICHAEL",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-18",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "3013639",
"primary": true
}
],
"identifiers": [],
"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 Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.