Individual provider Active NPI

Miriam Antoinette Bredella, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1861482028
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
326143 Issued in NY
Practice address
55 Fruit St
Radiological Associates Yaw 6
Boston, MA 02114-2696
Phone
(617) 726-7717
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 220247 MA
Diagnostic Radiology Physician 2085R0202X 326143 NY Primary

Addresses

Primary practice location

55 Fruit St
Radiological Associates Yaw 6
Boston, MA 02114-2696

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 726-7717

Other identifiers 3

IdentifierTypeStateIssuer
468985OtherTUFTS HEALTH PLAN
2068940MedicaidMA
J27258OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040702000815 MA Practitioner - Diagnostic Radiology 6305823709 Reassigns benefits to 2 organizations
I20231012000139 NY Practitioner - Diagnostic Radiology 6305823709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

111 Broadway
FL 2
New York, NY 10006-1995
Phone (212) 263-9701

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

145 E 32 St
New York, NY 10016-6055
Phone (212) 263-3210

145 E 32ND St
FL 2
New York, NY 10016-6055
Phone (212) 263-3210

150 E 32ND St
New York, NY 10016-6058
Phone (212) 263-3049

159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300

16 TH St and 1St Ave
New York, NY 10003-3804
Phone (212) 420-2000

160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

2318 31St St
Suite 200
Astoria, NY 11105-2765
Phone (718) 777-7742

301 E 17TH St
New York, NY 10003-3804
Phone (212) 263-7300

333 E 38TH St
New York, NY 10016-2772
Phone (646) 356-9400

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

660 1St Ave
New York, NY 10016-3295
Phone (212) 263-7300

715 Roanoke Ave
Riverhead, NY 11901-2769
Phone (516) 541-5500

74 Kent St
Brooklyn, NY 11222-1517
Phone (516) 365-4949

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220247MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
New York University CurrentSince Aug 29, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Jul 26, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2004 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 25, 2024 Accepting new patients
New York University CurrentSince Aug 29, 2023 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 25, 2024 Accepting new patients

Locations

55 Fruit St
#6
Boston, MA 02114
Phone (617) 724-8958

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: bredella.miriam.mgh@direct.partners.masshiway.net
  • Direct secure messaging: mbredella587513@nyumc.direct-ci.com

Organizations & group practices 8

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 9

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1861482028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-726-7717",
            "fax_number": "617-726-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "RADIOLOGICAL ASSOCIATES YAW 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDELLA",
        "first_name": "MIRIAM",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "220247",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "326143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "468985",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2068940",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J27258",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.