NPIMap

Individual provider Active NPI

Suzanne E Gleysteen, M.D.

  • Internal Medicine Physician
  • Brookline, MA
National Provider Identifier
1871608836
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
80333 Issued in MA
Practice address
637 Washington St
Suite 100
Brookline, MA 02446-4500
Phone
(617) 754-1700
NPI assigned
Aug 20, 2006
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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 80333 MA Primary

Addresses

Primary practice location

637 Washington St
Suite 100
Brookline, MA 02446-4500

Mailing address

19 Elm St
Wellesley, MA 02481-3106
Phone (617) 754-1700

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
I20050628001147 MA Practitioner - Internal Medicine 8628014859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

637 Washington St
Brookline, MA 02446-4500
Phone (617) 734-3636

93 Pond St
Sharon, MA 02067-2015
Phone (781) 784-9212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3306MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation Internal Medicine CurrentSince Jul 1, 1995 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine Past Accepting new patients
Longwood MRI Specialists Inc. Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

637 Washington St
Brookline, MA 02446
Phone (617) 232-2811

637 Washington St
Ste 100
Brookline, MA 02446
Phone (617) 525-6969

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Organizations & group practices 3

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 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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1871608836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ELM ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024813106",
            "telephone_number": "617-754-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "address_2": "SUITE 100",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464500",
            "telephone_number": "617-754-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEYSTEEN",
        "first_name": "SUZANNE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "80333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.