Individual provider Active NPI

Ronald E Iverson Jr., MD

  • Obstetrics & Gynecology Physician
  • Boston, MA
National Provider Identifier
1942290796
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
151356 Issued in MA
Practice address
850 Harrison Ave
Yawkey 4TH Floor
Boston, MA 02118-4001
Phone
(617) 414-2000
Fax
(617) 414-5798
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 151356 MA Primary

Addresses

Primary practice location

850 Harrison Ave
Yawkey 4TH Floor
Boston, MA 02118-4001

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other practice location 1

55 Fruit Street
Boston, MA 02114-2696
Phone (617) 724-3718

Other identifiers 1

IdentifierTypeStateIssuer
110057238AMedicaidMA

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
I20040812001248 MA Practitioner - Obstetrics/Gynecology 4880667484 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 15, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Dec 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Obstetrics & Gynecology CurrentSince Oct 15, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 15, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 15, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 15, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Obstetrics & Gynecology CurrentSince Dec 1, 2024 Accepting new patients
Boston Medical Center Corporation Past Accepting new patients

Locations

55 Fruit St
#1053
Boston, MA 02114
Phone (617) 724-2229

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

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

Organizations & group practices 8

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1942290796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YAWKEY 4TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit Street",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-724-3718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "RONALD",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "151356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110057238A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.