Individual provider Active NPI

Marisa Bren Roberts, MD

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1932529005
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
270085 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 754-2323
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 270085 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Boston, MA 02215-5400

Other identifiers 1

IdentifierTypeStateIssuer
110121666AMedicaidMA

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
I20170601002716 MA Practitioner - Emergency Medicine 9638446297 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Page St
New Bedford, MA 02740-3464
Phone (508) 679-3131

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2017 Accepting new patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

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

910 Washington St
Dedham, MA 02026
Phone (781) 431-1333

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

100 Highland St
Milton, MA 02186
Phone (617) 615-4000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 Walter J Hannon Pkwy
Ste 143
Quincy, MA 02169
Phone (617) 615-4000

Interoperability endpoints

  • Direct secure messaging: mroberts252646@direct.bilh.masshiway.net

Organizations & group practices 10

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1932529005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-754-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARISA",
        "middle_name": "BREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "270085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110121666A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.