Active NPI
Ayushi Gautam
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1801648472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 330 Brookline Ave
Boston, MA 02215-5400 - Phone
- (617) 667-7000
- NPI assigned
- Apr 4, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
330 Brookline Ave
Boston, MA 02215-5400
Mailing address
330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240807004059 | MA | Order and Referring Only - Internal Medicine | 4183161128 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1801648472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTAM",
"first_name": "AYUSHI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-04",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.