NPIMap

Individual provider Active NPI

Alice L Zacarian, M.D.

  • Internal Medicine Physician
  • Waltham, MA
National Provider Identifier
1871580597
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
158523 Issued in MA
Practice address
355 Waverley Oaks Rd
Suite 200
Waltham, MA 02452-8474
Phone
(781) 647-6920
Fax
(781) 891-0056
NPI assigned
Sep 29, 2005
Last updated
Mar 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 158523 MA Primary

Addresses

Primary practice location

355 Waverley Oaks Rd
Suite 200
Waltham, MA 02452-8474

Mailing address

355 Waverley Oaks Rd
Suite 200
Waltham, MA 02452-8474
Phone (781) 647-6920

Other identifiers 1

IdentifierTypeStateIssuer
3192741MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000092 MA Practitioner - Internal Medicine 7810051778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Practice addresses (Care Compare)

57 Bedford St
Suite 130
Lexington, MA 02420-4543
Phone (781) 862-7500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Auburn Professional Services Internal Medicine CurrentSince Sep 12, 2013 Accepting new patients
Caritas Medical Group, Inc. Current Accepting new patients
Mount Auburn Professional Services Inc Internal Medicine CurrentSince Sep 12, 2013 Accepting new patients
Mt Auburn Prof Services Past Accepting new patients

Locations

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

355 Waverly Oaks Rd
Ste 200
Waltham, MA 02452
Phone (781) 647-6920

40 Spring St
Watertown, MA 02472
Phone (617) 923-8433

Interoperability endpoints

  • Direct secure messaging: azacarian254077@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1871580597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WAVERLEY OAKS RD",
            "address_2": "SUITE 200",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528474",
            "telephone_number": "781-647-6920",
            "fax_number": "781-891-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 WAVERLEY OAKS RD",
            "address_2": "SUITE 200",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528474",
            "telephone_number": "781-647-6920",
            "fax_number": "781-891-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACARIAN",
        "first_name": "ALICE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "158523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3192741",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.