Individual provider Active NPI

Elizaveta Ragulin Coyne, M.D.

  • Surgery Physician
  • Worcester, MA
National Provider Identifier
1932369741
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
245430 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-1000
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 245430 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

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
I20150911001327 MA Practitioner - General Surgery 8426365297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy21
Melanoma (skin cancer) excision12
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Emerson Hospital Past Accepting new patients

Locations

131 Ornac
Ste 500
Concord, MA 01742
Phone (978) 287-3547

131 Ornac
Ste 200
Concord, MA 01742
Phone (978) 287-3428

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: ragulincoyne.elizaveta.epa@direct.partners.masshiway.net

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.

Hospital & facility affiliations 1

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1932369741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGULIN COYNE",
        "first_name": "ELIZAVETA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "245430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.