Individual provider Active NPI

Stephanie T. Osiecki, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1922080464
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
203867 Issued in MA
Practice address
100 Cambridge St FL 14
Boston, MA 02114-2509
Phone
(888) 731-8994
Fax
(888) 732-8119
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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 203867 MA Primary

Addresses

Primary practice location

100 Cambridge St FL 14
Boston, MA 02114-2509

Mailing address

100 Cambridge St FL 14
Boston, MA 02114-2509
Phone (888) 731-8994

Other practice location 1

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923
Phone (888) 731-8994

Other practice location 2

721 Depot Dr
Anchorage, AK 99501-1615
Phone (888) 731-8994

Other identifiers 15

IdentifierTypeStateIssuer
A30786OtherMABCBS MA
203867OtherMACONNECTICARE
9560323OtherMACIGNA
042104788OtherMACONSOLIDATED
042104788OtherMANORTHEAST HEALTH DIRECT
042104788OtherMAUNICARE/GIC
3207749MedicaidMA
467855OtherMATUFTS
042104788OtherMAGREAT-WEST HEALTH PLAN
042104788OtherMANORTH AMERICAN PREFERRED
042104788OtherMAPRIVATE HEALTH CARE SYS.
14912OtherMAHEALTH NEW ENGLAND
7137629OtherMAAETNA
042104788OtherMANORTHEAST HEALTHCARE ALLI
AA24783OtherMAHARVARD PILGRIM HEALTHCAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000212 MA Practitioner - Internal Medicine 0840354452

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Womens Care PC Past Accepting new patients
Cooley Dickinson Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.osiecki.1@27069.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1922080464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "888-731-8994",
            "fax_number": "888-732-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "888-731-8994",
            "fax_number": "888-732-8119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N Saint Paul St Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752013923",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "fax_number": "888-732-8119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "721 Depot Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995011615",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "fax_number": "888-732-8119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSIECKI",
        "first_name": "STEPHANIE",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "203867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "A30786",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "203867",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9560323",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSOLIDATED",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTH DIRECT",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE/GIC",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3207749",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "467855",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT-WEST HEALTH PLAN",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN PREFERRED",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE SYS.",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "14912",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7137629",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTHCARE ALLI",
            "identifier": "042104788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA24783",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.