Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
Organization Active NPI Vascular Surgery Physician · Boston, MA
NPI 1891736310 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1891736310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- Legal business name
- HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
- Practice address
- 330 Brookline Ave
Boston, MA 02215 - Phone
- (617) 632-7390
- NPI assigned
- Jun 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Alexandra Boer Kimball, MD
- Title
- Chief Executive Officer
- Phone
- (617) 632-7444
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 28
Practitioners 1,726
-
Elliot L Chaikof, MD
-
Louis Chu, M.D.
-
Kristin Fleischmann-Rose, N.P.
-
Allen D Hamdan, M.D.
-
Kamal Ramez Khabbaz, M.D.
-
Andy M Lee, M.D.
-
David C Liu, MD
-
Ryan Piotrowski, PA-C
-
Venkatachalam Senthilnathan, MD, FRCS
-
Brooks Templeton, PA-C
-
Richard Ian Whyte, M.D.
-
Jacques Kpodonu, M.D.
-
Gerardina Bueti, PA-C
-
Elizabeth Marks, PA-C
-
Shihchung Albert Woo, M.D.
-
Courtney Joan Gemmato, M.D.
-
Cheryl L Curtis, P.A. -C
-
Amtul Aala, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031204000042 | MA | Part B Supplier - Clinic/Group Practice | 4486567104 |
Receives reassigned benefits from 22 practitioners Practice locations: Boston, MA; Brighton, MA |
National Provider Directory
- Tax ID family
- Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce
Locations
375 Longwood Ave
Ste 3B
Boston, MA 02215
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | Yes |
Addresses
Primary practice location
330 Brookline Ave
Boston, MA 02215
Mailing address
375 Longwood Ave Ste 3B
Boston, MA 02215-5395
Phone (781) 528-2835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9760911 | Medicaid | MA |
Other names
- Vascular/Surgery - HMFP at BIDMC
Other providers in Boston, MA
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
All providers in Boston, MA · Vascular Surgery Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.