NPIMap

Individual provider Active NPI

Eduardo O Dagostino, MD

  • Anesthesiology Physician
  • Andover, MA
National Provider Identifier
1912907718
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
44715 Issued in MA
Practice address
349 N Main St
Andover, MA 01810-2687
Phone
(978) 475-0959
Fax
(978) 475-1769
NPI assigned
Jul 22, 2005
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 44715 MA Primary

Addresses

Primary practice location

349 N Main St
Andover, MA 01810-2687

Mailing address

181 Wells Ave Ste 302
Newton, MA 02459-3344
Phone (781) 972-7136

Other practice location 1

91 Montvale Ave Ste 302
Stoneham, MA 02180-3649
Phone (781) 438-5995

Other identifiers 2

IdentifierTypeStateIssuer
C04853OtherBLUE SHIELD
0104086MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.85 of 100Reported as group
Quality
77.71
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44715MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivs Anesthesia, LLC Anesthesiology CurrentSince Feb 1, 1980 Accepting new patients
Massachusetts Anesthesia Corporation Past Accepting new patients
Merrimack Valley Anesthesia Associates, PC Anesthesiology Past Accepting new patients
Emerson Practice Associates II, Inc. PastSince Dec 13, 2022 Accepting new patients
Merrimack Valley Anesthesia Anesthesiology Past Accepting new patients

Locations

349 N Main St
Andover, MA 01810
Phone (978) 475-0959

140 Lincoln Ave
Haverhill, MA 01830
Phone (978) 374-2000

181 Wells Ave
Ste 302
Newton Center, MA 02459

91 Montvale Ave
Ste 302
Stoneham, MA 02180
Phone (781) 438-5995

690 Canton St
Ste 325
Westwood, MA 02090
Phone 7814077713307

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1912907718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 WELLS AVE STE 302",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024593344",
            "telephone_number": "781-972-7136",
            "fax_number": "781-972-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 N MAIN ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102687",
            "telephone_number": "978-475-0959",
            "fax_number": "978-475-1769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Montvale Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Stoneham",
            "state": "MA",
            "postal_code": "021803649",
            "country_code": "US",
            "telephone_number": "781-438-5995",
            "fax_number": "781-279-1238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAGOSTINO",
        "first_name": "EDUARDO",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "44715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "C04853",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104086",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.